| Richmond Counseling Llc | |
|
5270 Northland Dr Ne Ste B Grand Rapids MI 49525-1073 | |
| (616) 514-8860 | |
| Not Available |
| Full Name | Richmond Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5270 Northland Dr Ne Ste B, Grand Rapids, 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 |
|---|---|
| Richmond Counseling Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Richmond Counseling Llc 5270 Northland Dr Ne Ste B Grand Rapids MI 49525-1073 Ph: (616) 514-8860 |
| NPI Number | 1750862470 |
|---|---|
| Provider Enumeration Date | 08/22/2018 |
| Last Update Date | 12/12/2019 |
| Certification Date | 12/12/2019 |
| Medicare PECOS PAC ID | 9739439829 |
|---|---|
| Medicare Enrollment ID | O20180911003150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750862470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801064001 (Michigan) | Primary |
| Provider Name | Kenneth L Richmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245341940 PECOS PAC ID: 0840542445 Enrollment ID: I20181009003634 |
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