| Laverne Santangelo | |
|
48048 Burton Dr Shelby Township MI 48317-2406 | |
| (586) 945-4949 | |
| Not Available |
| Full Name | Laverne Santangelo |
|---|---|
| Speciality | Counselor |
| Location | 48048 Burton Dr, Shelby Township, Michigan |
| Authorized Official Name and Position | Laverne Santangelo (LICENSE PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 5869454949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laverne Santangelo 48048 Burton Dr Shelby Township MI 48317-2406 Ph: (586) 945-4949 | Laverne Santangelo 48048 Burton Dr Shelby Township MI 48317-2406 Ph: (586) 945-4949 |
| NPI Number | 1700665015 |
|---|---|
| Provider Enumeration Date | 09/26/2023 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 9133564941 |
|---|---|
| Medicare Enrollment ID | O20240304000841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700665015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Laverne Santangelo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568755338 PECOS PAC ID: 0042655854 Enrollment ID: I20240304000922 |
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