| Prospicare Pllc | |
|
1409 Cherokee St Kalamazoo MI 49006-2015 | |
| (269) 352-7922 | |
| Not Available |
| Full Name | Prospicare Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1409 Cherokee St, Kalamazoo, 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 |
|---|---|
| Prospicare Pllc 1409 Cherokee St Kalamazoo MI 49006-2015 Ph: (269) 352-7922 | Prospicare Pllc 1409 Cherokee St Kalamazoo MI 49006-2015 Ph: (269) 352-7922 |
| NPI Number | 1972041648 |
|---|---|
| Provider Enumeration Date | 02/02/2017 |
| Last Update Date | 05/27/2021 |
| Certification Date | 05/27/2021 |
| Medicare PECOS PAC ID | 4486939162 |
|---|---|
| Medicare Enrollment ID | O20170320001941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972041648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301016014 (Michigan) | Primary |
| Provider Name | Phyllis M Florian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023238623 PECOS PAC ID: 1951691278 Enrollment ID: I20160527000978 |
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