| Ldbt, Llc | |
|
36216 Freedom Rd Farmington Hills MI 48335-3002 | |
| (810) 813-0271 | |
| Not Available |
| Full Name | Ldbt, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 36216 Freedom Rd, Farmington Hills, Michigan |
| Authorized Official Name and Position | Lisa Neverdausky (OWNER) |
| Authorized Official Contact | 8108130271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ldbt, Llc 160 N Roosevelt St Apt 203 Canton MI 48187-4894 Ph: (810) 813-0271 | Ldbt, Llc 36216 Freedom Rd Farmington Hills MI 48335-3002 Ph: (810) 813-0271 |
| NPI Number | 1760265821 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 7810334026 |
|---|---|
| Medicare Enrollment ID | O20240325000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760265821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lisa A Neverdausky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245354984 PECOS PAC ID: 0648443358 Enrollment ID: I20111025000352 |
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