| Lifestyle Guidance Center Llc | |
|
53027 Hawald Dr Shelby Township MI 48316-3757 | |
| (586) 623-4160 | |
| (586) 623-4150 |
| Full Name | Lifestyle Guidance Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 53027 Hawald Dr, Shelby Township, Michigan |
| Authorized Official Name and Position | Emily Budzynowski (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 5866234160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestyle Guidance Center Llc 53027 Hawald Dr Shelby Township MI 48316-3757 Ph: (586) 623-4160 | Lifestyle Guidance Center Llc 53027 Hawald Dr Shelby Township MI 48316-3757 Ph: (586) 623-4160 |
| NPI Number | 1215671268 |
|---|---|
| Provider Enumeration Date | 04/26/2022 |
| Last Update Date | 04/26/2022 |
| Certification Date | 04/26/2022 |
| Medicare PECOS PAC ID | 6507218385 |
|---|---|
| Medicare Enrollment ID | O20240117002130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215671268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Donna Ann Berry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609313097 PECOS PAC ID: 4688025489 Enrollment ID: I20240105001822 |
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