| Purucker Counseling Services Pllc | |
|
100 S. Jefferson St. B Hastings MI 49058 | |
| (269) 331-0283 | |
| Not Available |
| Full Name | Purucker Counseling Services Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 100 S. Jefferson St., Hastings, Michigan |
| Authorized Official Name and Position | Colette Purucker (OWNER) |
| Authorized Official Contact | 2693890037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Purucker Counseling Services Pllc 816 S Church St Hastings MI 49058-2212 Ph: () - | Purucker Counseling Services Pllc 100 S. Jefferson St. B Hastings MI 49058 Ph: (269) 331-0283 |
| NPI Number | 1215507090 |
|---|---|
| Provider Enumeration Date | 06/25/2021 |
| Last Update Date | 06/29/2021 |
| Certification Date | 06/29/2021 |
| Medicare PECOS PAC ID | 2264834019 |
|---|---|
| Medicare Enrollment ID | O20210715002771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215507090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Colette R Purucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255852091 PECOS PAC ID: 9234498718 Enrollment ID: I20180108001533 |
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