New Leaf Therapy | |
1938 Burdette St Ferndale MI 48220-1982 | |
(313) 652-1510 | |
(248) 876-9454 |
Full Name | New Leaf Therapy |
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Speciality | Social Worker |
Location | 1938 Burdette St, Ferndale, Michigan |
Authorized Official Name and Position | Jennifer K Shea (OWNER) |
Authorized Official Contact | 3136521510 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New Leaf Therapy 1938 Burdette St Ferndale MI 48220-1982 Ph: (313) 652-1510 | New Leaf Therapy 1938 Burdette St Ferndale MI 48220-1982 Ph: (313) 652-1510 |
NPI Number | 1154801322 |
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Provider Enumeration Date | 08/17/2018 |
Last Update Date | 10/23/2023 |
Certification Date | 10/23/2023 |
Medicare PECOS PAC ID | 6204379183 |
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Medicare Enrollment ID | O20240620000191 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154801322 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801097641 (Michigan) | Primary |
Provider Name | Jennifer K Shea |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1730581414 PECOS PAC ID: 9830454636 Enrollment ID: I20180529000508 |
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