| Lkh Therapy Llc | |
|
2918 Chicago Drive Granville MI 49418 | |
| (616) 284-8152 | |
| Not Available |
| Full Name | Lkh Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2918 Chicago Drive, Granville, Michigan |
| Authorized Official Name and Position | Nicole Nutt (OWNER) |
| Authorized Official Contact | 6162848152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lkh Therapy Llc 2918 Chicago Drive Granville MI 49418 Ph: (616) 284-8152 | Lkh Therapy Llc 2918 Chicago Drive Granville MI 49418 Ph: (616) 284-8152 |
| NPI Number | 1023760527 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Medicare PECOS PAC ID | 9931596814 |
|---|---|
| Medicare Enrollment ID | O20220422001794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023760527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole Nutt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871048934 PECOS PAC ID: 3779831953 Enrollment ID: I20180803001443 |
| Provider Name | Cameron Mitchell Wolbrink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962055467 PECOS PAC ID: 8325492291 Enrollment ID: I20230926002574 |
| Provider Name | Charlotte Ann Junewick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457986036 PECOS PAC ID: 5395199285 Enrollment ID: I20230926003322 |