| Neeshan Mehretu Lmsw Llc | |
|
4572 S Hagadorn Rd Ste 3c East Lansing MI 48823-5385 | |
| (517) 896-2766 | |
| Not Available |
| Full Name | Neeshan Mehretu Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4572 S Hagadorn Rd Ste 3c, East Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neeshan Mehretu Lmsw Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Neeshan Mehretu Lmsw Llc 4572 S Hagadorn Rd Ste 3c East Lansing MI 48823-5385 Ph: (517) 896-2766 |
| NPI Number | 1912664251 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Certification Date | 11/22/2021 |
| Medicare PECOS PAC ID | 7618369166 |
|---|---|
| Medicare Enrollment ID | O20220113002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912664251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Neeshan Mehretu-harmenil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710430277 PECOS PAC ID: 5294088423 Enrollment ID: I20181105002040 |
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