| Reineke Consulting, Llc | |
|
2020 Raybrook St Se Ste 308 Grand Rapids MI 49546-7717 | |
| (616) 649-1010 | |
| (616) 551-2895 |
| Full Name | Reineke Consulting, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2020 Raybrook St Se Ste 308, Grand Rapids, Michigan |
| Authorized Official Name and Position | Lori Reineke (PRESIDENT) |
| Authorized Official Contact | 6166491010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reineke Consulting, Llc 2020 Raybrook St Se Ste 308 Grand Rapids MI 49546-7717 Ph: (616) 649-1010 | Reineke Consulting, Llc 2020 Raybrook St Se Ste 308 Grand Rapids MI 49546-7717 Ph: (616) 649-1010 |
| NPI Number | 1952780686 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 04/21/2023 |
| Certification Date | 04/21/2023 |
| Medicare PECOS PAC ID | 4486964632 |
|---|---|
| Medicare Enrollment ID | O20151030001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952780686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 6301009314 (Michigan) | Primary |
| 103TC0700X | Psychologist - Clinical | 6301009314 (Michigan) | Secondary |
| Provider Name | Lori J Reineke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790765170 PECOS PAC ID: 1658552070 Enrollment ID: I20110217000891 |
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