| Mbj Counseling Pc | |
|
107 Woodland Court Suite B Michigan City IN 46360 | |
| (219) 336-4866 | |
| Not Available |
| Full Name | Mbj Counseling Pc |
|---|---|
| Speciality | Social Worker |
| Location | 107 Woodland Court Suite B, Michigan City, Indiana |
| Authorized Official Name and Position | Michelle Bazin-johnson (PRESIDENT) |
| Authorized Official Contact | 2193364866 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbj Counseling Pc 107 Woodland Court Suite B Michigan City IN 46360 Ph: (219) 336-4866 | Mbj Counseling Pc 107 Woodland Court Suite B Michigan City IN 46360 Ph: (219) 336-4866 |
| NPI Number | 1942986864 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Medicare PECOS PAC ID | 6800258500 |
|---|---|
| Medicare Enrollment ID | O20230811002471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942986864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle K Bazin Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124631528 PECOS PAC ID: 1456327956 Enrollment ID: I20040907000698 |
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