| Paladins Perspective | |
|
37 E Main St Ste G Fremont MI 49412-1295 | |
| (231) 233-1097 | |
| Not Available |
| Full Name | Paladins Perspective |
|---|---|
| Speciality | Counselor |
| Location | 37 E Main St Ste G, Fremont, Michigan |
| Authorized Official Name and Position | Kevin Hackworth (COUNSELOR) |
| Authorized Official Contact | 2312331097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paladins Perspective 7322 Rolling Rd Newaygo MI 49337-8702 Ph: (231) 233-1097 | Paladins Perspective 37 E Main St Ste G Fremont MI 49412-1295 Ph: (231) 233-1097 |
| NPI Number | 1922502970 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 2163873647 |
|---|---|
| Medicare Enrollment ID | O20240109002825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922502970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kevin L Hackworth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265980395 PECOS PAC ID: 7517318090 Enrollment ID: I20240109002898 |
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