| Shirley Claassen Dick Llc | |
|
1930 W Lincoln Ave Goshen IN 46526-5907 | |
| (574) 534-2161 | |
| Not Available |
| Full Name | Shirley Claassen Dick Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1930 W Lincoln Ave, Goshen, Indiana |
| Authorized Official Name and Position | Shirley Claassen Dick (SOLE MEMBER) |
| Authorized Official Contact | 5742385842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shirley Claassen Dick Llc 1930 W Lincoln Ave Goshen IN 46526-5907 Ph: (574) 534-2161 | Shirley Claassen Dick Llc 1930 W Lincoln Ave Goshen IN 46526-5907 Ph: (574) 534-2161 |
| NPI Number | 1104299783 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 11/04/2015 |
| Medicare PECOS PAC ID | 3870895857 |
|---|---|
| Medicare Enrollment ID | O20160107002143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104299783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34001401A (Indiana) | Primary |
| Provider Name | Shirley K Dick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558706358 PECOS PAC ID: 7517109606 Enrollment ID: I20130820000913 |
Change Architects Llp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1930 W Lincoln Ave, Goshen, IN 46526 Phone: 574-534-2161 Fax: 574-534-3887 | |
Carly Lantz Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 S 3rd St, Goshen, IN 46526 Phone: 574-538-7960 | |
Lauren Boyle Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1930 W Lincoln Ave, Goshen, IN 46526 Phone: 574-534-2161 Fax: 574-534-3887 | |
Wade Psychological Services Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1930 W Lincoln Ave, Goshen, IN 46526 Phone: 574-534-2161 Fax: 574-534-3887 | |
Jennifer Miller Counseling, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1930 W Lincoln Ave, Goshen, IN 46526 Phone: 574-534-2161 Fax: 574-534-3887 | |
Carrie Sommer Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1930 W Lincoln Ave, Goshen, IN 46526 Phone: 574-534-2161 |