| Living Fully Mental Health Plc | |
|
8305 S Saginaw St Ste 6 Grand Blanc MI 48439-1894 | |
| (810) 201-4789 | |
| (248) 301-1076 |
| Full Name | Living Fully Mental Health Plc |
|---|---|
| Speciality | Social Worker |
| Location | 8305 S Saginaw St Ste 6, Grand Blanc, Michigan |
| Authorized Official Name and Position | Kenneth Scott Lounds (PARTNER) |
| Authorized Official Contact | 8102014789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Fully Mental Health Plc 8305 S Saginaw St Ste 6 Grand Blanc MI 48439-1894 Ph: (810) 201-4789 | Living Fully Mental Health Plc 8305 S Saginaw St Ste 6 Grand Blanc MI 48439-1894 Ph: (810) 201-4789 |
| NPI Number | 1881379584 |
|---|---|
| Provider Enumeration Date | 06/20/2023 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 1456714575 |
|---|---|
| Medicare Enrollment ID | O20230822003964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881379584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kenneth S Lounds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184867186 PECOS PAC ID: 7012170517 Enrollment ID: I20120521000286 |
| Provider Name | Susan Pesha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376786293 PECOS PAC ID: 0749644482 Enrollment ID: I20240425001405 |
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