| Soulrise Mental Health | |
|
2652 Spring Arbor Rd Jackson MI 49203-3604 | |
| (517) 798-6712 | |
| Not Available |
| Full Name | Soulrise Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 2652 Spring Arbor Rd, Jackson, 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 |
|---|---|
| Soulrise Mental Health Po Box 10 Mason MI 48854-0010 Ph: () - | Soulrise Mental Health 2652 Spring Arbor Rd Jackson MI 49203-3604 Ph: (517) 798-6712 |
| NPI Number | 1154003606 |
|---|---|
| Provider Enumeration Date | 08/03/2023 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 1951764661 |
|---|---|
| Medicare Enrollment ID | O20230829001390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154003606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Rebecca Goldsmith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841915014 PECOS PAC ID: 2860855574 Enrollment ID: I20230829001643 |
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