| Body Spirit Mind | |
|
206 S Main St Ste 201 Ann Arbor MI 48104-2114 | |
| (313) 479-4605 | |
| Not Available |
| Full Name | Body Spirit Mind |
|---|---|
| Speciality | Social Worker |
| Location | 206 S Main St Ste 201, Ann Arbor, Michigan |
| Authorized Official Name and Position | Poonam Sripada (OWNER) |
| Authorized Official Contact | 3134794605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Body Spirit Mind 206 S Main St Ste 201 Ann Arbor MI 48104-2114 Ph: (313) 479-4605 | Body Spirit Mind 206 S Main St Ste 201 Ann Arbor MI 48104-2114 Ph: (313) 479-4605 |
| NPI Number | 1740857317 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 0244627495 |
|---|---|
| Medicare Enrollment ID | O20220419000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740857317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Poonam R Sripada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174889539 PECOS PAC ID: 6103106976 Enrollment ID: I20161213002317 |
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