| Silver Lake Counseling | |
|
14165 N Fenton Rd Ste 102a Fenton MI 48430-1148 | |
| (810) 428-7909 | |
| (810) 519-8063 |
| Full Name | Silver Lake Counseling |
|---|---|
| Speciality | Counselor |
| Location | 14165 N Fenton Rd Ste 102a, Fenton, Michigan |
| Authorized Official Name and Position | Teresa L. Fowler (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8104287909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Lake Counseling 14165 N Fenton Rd Ste 102a Fenton MI 48430-1148 Ph: (810) 428-7909 | Silver Lake Counseling 14165 N Fenton Rd Ste 102a Fenton MI 48430-1148 Ph: (810) 428-7909 |
| NPI Number | 1750078390 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Medicare PECOS PAC ID | 6901242981 |
|---|---|
| Medicare Enrollment ID | O20240313000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750078390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Teresa Fowler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629748421 PECOS PAC ID: 7719323799 Enrollment ID: I20240313000579 |
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