| Mjr Wellness Counseling, Pllc | |
|
401 Center St South Haven MI 49090-1315 | |
| (269) 961-1098 | |
| Not Available |
| Full Name | Mjr Wellness Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 Center St, South Haven, Michigan |
| Authorized Official Name and Position | Maria Jesus Rivera (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2699611098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mjr Wellness Counseling, Pllc 80 Elkenburg St South Haven MI 49090-1275 Ph: (269) 961-1098 | Mjr Wellness Counseling, Pllc 401 Center St South Haven MI 49090-1315 Ph: (269) 961-1098 |
| NPI Number | 1548936214 |
|---|---|
| Provider Enumeration Date | 08/21/2021 |
| Last Update Date | 08/21/2021 |
| Certification Date | 08/21/2021 |
| Medicare PECOS PAC ID | 5890130041 |
|---|---|
| Medicare Enrollment ID | O20240228001111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548936214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Maria Rivera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457897399 PECOS PAC ID: 9931546348 Enrollment ID: I20240321000425 |
| Provider Name | Surilla Lawrence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376100222 PECOS PAC ID: 7618419698 Enrollment ID: I20240605002301 |
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