| Mindful Balance Mental Health & Wellness, Llc | |
|
1124 Gratiot Blvd Marysville MI 48040-1133 | |
| (810) 434-0462 | |
| Not Available |
| Full Name | Mindful Balance Mental Health & Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1124 Gratiot Blvd, Marysville, Michigan |
| Authorized Official Name and Position | Robert Damien Perrin (OWNER) |
| Authorized Official Contact | 8104340462 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Balance Mental Health & Wellness, Llc 5325 Lockwood Dr Washington MI 48094-2632 Ph: (586) 214-2218 | Mindful Balance Mental Health & Wellness, Llc 1124 Gratiot Blvd Marysville MI 48040-1133 Ph: (810) 434-0462 |
| NPI Number | 1316646953 |
|---|---|
| Provider Enumeration Date | 03/02/2023 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Medicare PECOS PAC ID | 2961867775 |
|---|---|
| Medicare Enrollment ID | O20230501001913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316646953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robert D Perrin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548221500 PECOS PAC ID: 2567369937 Enrollment ID: I20031215000407 |
| Provider Name | Samantha Lmsw Morawa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245680560 PECOS PAC ID: 6204245749 Enrollment ID: I20210512003071 |
| Provider Name | Renee Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407224413 PECOS PAC ID: 5698174456 Enrollment ID: I20210527000486 |
| Provider Name | Jennifer Hutkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538609656 PECOS PAC ID: 5799185203 Enrollment ID: I20210621000454 |
| Provider Name | Lauren Sadocha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972142958 PECOS PAC ID: 1951754308 Enrollment ID: I20240201001534 |
| Provider Name | Karleigh Knox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538735014 PECOS PAC ID: 4880038579 Enrollment ID: I20240221002803 |
| Provider Name | Morgan Shafer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437673696 PECOS PAC ID: 2961847215 Enrollment ID: I20240227001943 |
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