| Mmg Psychotherapy Llc | |
|
520 Ne 20th Street #603 Wilton Manors FL 33305 | |
| (561) 578-9348 | |
| (866) 757-5778 |
| Full Name | Mmg Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 520 Ne 20th Street, Wilton Manors, Florida |
| Authorized Official Name and Position | Michael Gans (OWNER/MBR) |
| Authorized Official Contact | 5615789348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmg Psychotherapy Llc 520 Ne 20th Street #603 Wilton Manors FL 33305 Ph: (561) 578-9348 | Mmg Psychotherapy Llc 520 Ne 20th Street #603 Wilton Manors FL 33305 Ph: (561) 578-9348 |
| NPI Number | 1255957346 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 06/24/2020 |
| Certification Date | 06/24/2020 |
| Medicare PECOS PAC ID | 5890111934 |
|---|---|
| Medicare Enrollment ID | O20200819002306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255957346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michael M Gans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982244331 PECOS PAC ID: 2668801895 Enrollment ID: I20200408004726 |
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