| Segue Inc | |
|
212 E. Biddle Street Jackson MI 49203 | |
| (517) 784-6729 | |
| (517) 745-4841 |
| Full Name | Segue Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 E. Biddle Street, Jackson, Michigan |
| Authorized Official Name and Position | Diane M Reynolds (CEO) |
| Authorized Official Contact | 5177846729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Segue Inc Po Box 6159 Jackson MI 49204-6159 Ph: (517) 784-6729 | Segue Inc 212 E. Biddle Street Jackson MI 49203 Ph: (517) 784-6729 |
| NPI Number | 1174634315 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 02/03/2020 |
| Certification Date | 02/03/2020 |
| Medicare PECOS PAC ID | 6800891680 |
|---|---|
| Medicare Enrollment ID | O20060929000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174634315 | NPI | - | NPPES |
| 260C811710 | Other | MI | BLUE CROSS BLUE SHLD MICH |
| 4924298 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Christina I Zachar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265534804 PECOS PAC ID: 8022060318 Enrollment ID: I20050215000517 |
| Provider Name | Penny E Jansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922122845 PECOS PAC ID: 2365547197 Enrollment ID: I20070424000324 |
| Provider Name | Anne Michelle Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457926701 PECOS PAC ID: 6103221056 Enrollment ID: I20210816003483 |
| Provider Name | Ted Nicholas Jansen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629191523 PECOS PAC ID: 0648376947 Enrollment ID: I20240110000773 |
| Provider Name | Diana Allen Welsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710631692 PECOS PAC ID: 0143672501 Enrollment ID: I20240122001922 |
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