Peripheral Counseling Llc | |
4867 E Beltline Ave Ne Ste 400 Grand Rapids MI 49525-9787 | |
(989) 745-1933 | |
Not Available |
Full Name | Peripheral Counseling Llc |
---|---|
Speciality | Counselor |
Location | 4867 E Beltline Ave Ne Ste 400, Grand Rapids, Michigan |
Authorized Official Name and Position | Kyle Handrich (OWNER) |
Authorized Official Contact | 9897451933 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Peripheral Counseling Llc 1510 Derby Dr Nw Grand Rapids MI 49504-2678 Ph: () - | Peripheral Counseling Llc 4867 E Beltline Ave Ne Ste 400 Grand Rapids MI 49525-9787 Ph: (989) 745-1933 |
NPI Number | 1417778929 |
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Provider Enumeration Date | 10/18/2024 |
Last Update Date | 10/18/2024 |
Certification Date | 10/18/2024 |
Medicare PECOS PAC ID | 0941734487 |
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Medicare Enrollment ID | O20241106003656 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417778929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Provider Name | Kyle Handrich |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1205554615 PECOS PAC ID: 5395279830 Enrollment ID: I20241106003765 |
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