| Sacks Clinical Consulting, Pc | |
|
107 Woodland Ct Ste B Michigan City IN 46360-7392 | |
| (219) 628-6463 | |
| (219) 809-0200 |
| Full Name | Sacks Clinical Consulting, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 107 Woodland Ct, Michigan City, Indiana |
| Authorized Official Name and Position | Sharon Sacks (OWNER) |
| Authorized Official Contact | 2192100111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacks Clinical Consulting, Pc 107 Woodland Ct Ste B Michigan City IN 46360-7392 Ph: (219) 628-6463 | Sacks Clinical Consulting, Pc 107 Woodland Ct Ste B Michigan City IN 46360-7392 Ph: (219) 628-6463 |
| NPI Number | 1548567241 |
|---|---|
| Provider Enumeration Date | 02/16/2011 |
| Last Update Date | 02/22/2011 |
| Medicare PECOS PAC ID | 9335320134 |
|---|---|
| Medicare Enrollment ID | O20110228000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548567241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 20041854A (Indiana) | Primary |
| Provider Name | Jeffrey L Samelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801866223 PECOS PAC ID: 1759354251 Enrollment ID: I20040813000494 |
| Provider Name | Sharon Kay Sacks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437187606 PECOS PAC ID: 6204850555 Enrollment ID: I20060125000560 |
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