| Lifelens Psychological And Counseling Services, Pllc | |
|
4000 W Walton Blvd Suite B Waterford MI 48329-4191 | |
| (248) 881-6698 | |
| Not Available |
| Full Name | Lifelens Psychological And Counseling Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 4000 W Walton Blvd, Waterford, Michigan |
| Authorized Official Name and Position | Daniel Wall (OWNER) |
| Authorized Official Contact | 2488816698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelens Psychological And Counseling Services, Pllc 4000 W Walton Blvd Ste B Waterford MI 48329-4191 Ph: (248) 881-6698 | Lifelens Psychological And Counseling Services, Pllc 4000 W Walton Blvd Suite B Waterford MI 48329-4191 Ph: (248) 881-6698 |
| NPI Number | 1083015499 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Medicare PECOS PAC ID | 0143544320 |
|---|---|
| Medicare Enrollment ID | O20150116000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083015499 | NPI | - | NPPES |
| Provider Name | Daniel Wall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184901969 PECOS PAC ID: 1759500952 Enrollment ID: I20140922000781 |
| Provider Name | Ewa A Kubicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821306663 PECOS PAC ID: 0143575159 Enrollment ID: I20180615000403 |
| Provider Name | Karen Rusniak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760673909 PECOS PAC ID: 6507222858 Enrollment ID: I20230511003268 |
| Provider Name | Karen Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104234822 PECOS PAC ID: 8022474378 Enrollment ID: I20230511003291 |
| Provider Name | Nancy Ristich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639725849 PECOS PAC ID: 5395101646 Enrollment ID: I20230511003343 |
| Provider Name | David Sweet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982110789 PECOS PAC ID: 1658737903 Enrollment ID: I20230511003370 |
| Provider Name | Lyndsey Sleek-ristich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831690668 PECOS PAC ID: 0840654281 Enrollment ID: I20230918003900 |
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