| Mybody, Pllc | |
|
912 S Old Woodward Ave Ste 200 Birmingham MI 48009-6721 | |
| (248) 537-2639 | |
| Not Available |
| Full Name | Mybody, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 912 S Old Woodward Ave Ste 200, Birmingham, Michigan |
| Authorized Official Name and Position | Valerie Luxon (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2487912639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mybody, Pllc 912 S Old Woodward Ave Ste 200 Birmingham MI 48009-6721 Ph: (248) 537-2639 | Mybody, Pllc 912 S Old Woodward Ave Ste 200 Birmingham MI 48009-6721 Ph: (248) 537-2639 |
| NPI Number | 1447706213 |
|---|---|
| Provider Enumeration Date | 08/31/2016 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 7719305788 |
|---|---|
| Medicare Enrollment ID | O20200909000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447706213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301016242 (Michigan) | Primary |
| Provider Name | Valerie R Luxon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730467812 PECOS PAC ID: 8224295878 Enrollment ID: I20150615002553 |
| Provider Name | Sydney A Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578997078 PECOS PAC ID: 0941584270 Enrollment ID: I20170222000369 |
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