| Tara C Fleis | |
|
308 Cleveland Ave Ste 114 Ishpeming MI 49849-1842 | |
| (906) 282-3130 | |
| (906) 323-4215 |
| Full Name | Tara C Fleis |
|---|---|
| Speciality | Clinic/Center |
| Location | 308 Cleveland Ave Ste 114, Ishpeming, Michigan |
| Authorized Official Name and Position | Tara Christeen Fleis (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9062823130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara C Fleis 308 Cleveland Ave Ste 114 Ishpeming MI 49849-1842 Ph: (906) 282-3130 | Tara C Fleis 308 Cleveland Ave Ste 114 Ishpeming MI 49849-1842 Ph: (906) 282-3130 |
| NPI Number | 1124644133 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 01/16/2024 |
| Certification Date | 01/16/2024 |
| Medicare PECOS PAC ID | 4587007992 |
|---|---|
| Medicare Enrollment ID | O20240213000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124644133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tara Christeen Fleis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760933121 PECOS PAC ID: 4789963000 Enrollment ID: I20240213000667 |
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