| Michigan Integrated Therapies | |
|
8080 Moorsbridge Rd Ste 102 Portage MI 49024-4422 | |
| (269) 762-1010 | |
| Not Available |
| Full Name | Michigan Integrated Therapies |
|---|---|
| Speciality | Counselor |
| Location | 8080 Moorsbridge Rd Ste 102, Portage, Michigan |
| Authorized Official Name and Position | Ashley Naumann (OFFICE MANAGER) |
| Authorized Official Contact | 4803267427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Integrated Therapies 8080 Moorsbridge Rd Ste 102 Portage MI 49024-4422 Ph: (269) 762-1010 | Michigan Integrated Therapies 8080 Moorsbridge Rd Ste 102 Portage MI 49024-4422 Ph: (269) 762-1010 |
| NPI Number | 1275032807 |
|---|---|
| Provider Enumeration Date | 02/09/2018 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Medicare PECOS PAC ID | 7719423680 |
|---|---|
| Medicare Enrollment ID | O20240726003721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275032807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4101006627 (Michigan) | Primary |
| Provider Name | Timothy D Henson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801228051 PECOS PAC ID: 6800196163 Enrollment ID: I20151118002851 |
| Provider Name | Corinne Renee Clancy Graber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073805834 PECOS PAC ID: 1355887977 Enrollment ID: I20240719000281 |
Michigan Integrated Therapies Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8080 Moorsbridge Rd Ste 102, Portage, MI 49024 Phone: 269-795-6681 | |
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