| Sandoval Counseling Services Llc | |
|
2223 Wellesley Dr Lansing MI 48911-1608 | |
| (517) 798-0460 | |
| Not Available |
| Full Name | Sandoval Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2223 Wellesley Dr, Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandoval Counseling Services Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Sandoval Counseling Services Llc 2223 Wellesley Dr Lansing MI 48911-1608 Ph: (517) 798-0460 |
| NPI Number | 1285402123 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 12/19/2023 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 8022468537 |
|---|---|
| Medicare Enrollment ID | O20231226001073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285402123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Patrick Sandoval |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629467691 PECOS PAC ID: 4183987662 Enrollment ID: I20180416000778 |
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