| Mercy Health - Life Counseling | |
|
125 E Southern Ave Muskegon MI 49442-5041 | |
| (231) 726-3582 | |
| (231) 722-6933 |
| Full Name | Mercy Health - Life Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 125 E Southern Ave, Muskegon, Michigan |
| Authorized Official Name and Position | Sandra Klein Horsman (DIRECTOR) |
| Authorized Official Contact | 2317263582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Health - Life Counseling 125 E Southern Ave Muskegon MI 49442-5041 Ph: (231) 726-3582 | Mercy Health - Life Counseling 125 E Southern Ave Muskegon MI 49442-5041 Ph: (231) 726-3582 |
| NPI Number | 1912954322 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 08/04/2015 |
| Medicare PECOS PAC ID | 8426001967 |
|---|---|
| Medicare Enrollment ID | O20050224000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912954322 | NPI | - | NPPES |
| 028369 | Other | MI | VALUE OPTIONS SUB ABUSE |
| 031611000 | Other | MI | MAGELLAN GROUP # |
| OF11343 | Other | MI | BCBS PSYCHOLOGIST GROUP |
| 20363 | Other | MI | BCBS - SUBSTANCE ABUSE FACILITY |
| OF10118 | Other | MI | BCS SOCIAL WORKER GROUP |
| 030234 | Other | MI | VALUE OPTIONS MENTAL HEAL |
| 0910713 | Other | MI | BCBS - OPC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 610004 (Michigan) | Primary |
| Provider Name | Karen R Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710071584 PECOS PAC ID: 0446249528 Enrollment ID: I20040512000770 |
| Provider Name | Katherine A Jawor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336188556 PECOS PAC ID: 0547233801 Enrollment ID: I20040816000296 |
| Provider Name | Karen E Newton-norder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073673513 PECOS PAC ID: 9739217381 Enrollment ID: I20100503000472 |
| Provider Name | Kourtnee J Naylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689964397 PECOS PAC ID: 5395922272 Enrollment ID: I20110601000461 |
| Provider Name | Eric E Erickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558342220 PECOS PAC ID: 9931157120 Enrollment ID: I20140211000643 |
| Provider Name | Bambi A Lahaie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275751406 PECOS PAC ID: 1759605579 Enrollment ID: I20150126001676 |
| Provider Name | Sri Venkata Uppalapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538489810 PECOS PAC ID: 4688987613 Enrollment ID: I20150721000616 |
| Provider Name | Joel S Wilkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356693618 PECOS PAC ID: 3274805809 Enrollment ID: I20170817000159 |
| Provider Name | Jennifer L Gustafson-stephenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407009046 PECOS PAC ID: 6204128044 Enrollment ID: I20180122001987 |
| Provider Name | Michelle Marie Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952898686 PECOS PAC ID: 5698030591 Enrollment ID: I20180524000616 |
| Provider Name | Samya Hawley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336351048 PECOS PAC ID: 0042515538 Enrollment ID: I20190423000528 |
| Provider Name | Allison Bryan Cortez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558748905 PECOS PAC ID: 6507291473 Enrollment ID: I20200123000340 |
| Provider Name | Teah M Waterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508301987 PECOS PAC ID: 7416238266 Enrollment ID: I20210512002842 |
| Provider Name | Mary Tackbary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588282784 PECOS PAC ID: 3274939814 Enrollment ID: I20210908001503 |
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