| Ml Counseling Llc | |
|
2976 Ivanrest Ave Sw Ste 205 Grandville MI 49418-1440 | |
| (269) 303-0088 | |
| Not Available |
| Full Name | Ml Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2976 Ivanrest Ave Sw Ste 205, Grandville, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ml Counseling Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Ml Counseling Llc 2976 Ivanrest Ave Sw Ste 205 Grandville MI 49418-1440 Ph: (269) 303-0088 |
| NPI Number | 1952868986 |
|---|---|
| Provider Enumeration Date | 02/26/2019 |
| Last Update Date | 10/29/2023 |
| Certification Date | 10/29/2023 |
| Medicare PECOS PAC ID | 9931539244 |
|---|---|
| Medicare Enrollment ID | O20200428000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952868986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Mandi L Esman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760832216 PECOS PAC ID: 2163703471 Enrollment ID: I20161228001901 |
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