| Premier Psychological Services, Pllc | |
|
1300 W Ridge St Suite 2 Marquette MI 49855-3194 | |
| (906) 228-6200 | |
| (906) 228-6244 |
| Full Name | Premier Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1300 W Ridge St, Marquette, Michigan |
| Authorized Official Name and Position | Gregory Sansom Jones (SOLE PROPRIETOR) |
| Authorized Official Contact | 9062286200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Psychological Services, Pllc 1300 W Ridge St Suite 2 Marquette MI 49855-3194 Ph: (906) 228-6200 | Premier Psychological Services, Pllc 1300 W Ridge St Suite 2 Marquette MI 49855-3194 Ph: (906) 228-6200 |
| NPI Number | 1619109501 |
|---|---|
| Provider Enumeration Date | 08/11/2009 |
| Last Update Date | 09/22/2022 |
| Certification Date | 09/22/2022 |
| Medicare PECOS PAC ID | 8224267539 |
|---|---|
| Medicare Enrollment ID | O20140207001568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619109501 | NPI | - | NPPES |
| 0E20205 | Other | MI | BCBS PROVIDER |
| 0E20193 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301010832 (Michigan) | Primary |
| Provider Name | Gregory S Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245214451 PECOS PAC ID: 6305877820 Enrollment ID: I20050824000980 |
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