| Midstream Counseling Plc | |
|
6668 S West Bay Shore Dr Traverse City MI 49684-9205 | |
| (231) 590-9743 | |
| (231) 421-5616 |
| Full Name | Midstream Counseling Plc |
|---|---|
| Speciality | Social Worker |
| Location | 6668 S West Bay Shore Dr, Traverse City, Michigan |
| Authorized Official Name and Position | David Paul Agee (CO-OWNER THERAPIST) |
| Authorized Official Contact | 2315909743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midstream Counseling Plc 6668 S West Bay Shore Dr Traverse City MI 49684-9205 Ph: (231) 590-9743 | Midstream Counseling Plc 6668 S West Bay Shore Dr Traverse City MI 49684-9205 Ph: (231) 590-9743 |
| NPI Number | 1184177180 |
|---|---|
| Provider Enumeration Date | 07/27/2016 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Medicare PECOS PAC ID | 1557658150 |
|---|---|
| Medicare Enrollment ID | O20160926001564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184177180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801079803 (Michigan) | Primary |
| 1041C0700X | Social Worker - Clinical | 6801087281 (Michigan) | Secondary |
| Provider Name | David P Agee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649319849 PECOS PAC ID: 9638272669 Enrollment ID: I20070313000363 |
| Provider Name | Pamela A Agee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518160233 PECOS PAC ID: 2466584073 Enrollment ID: I20100717000131 |
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