| Steven J Ceresnie Phd Pc | |
|
199 N Main St Plymouth MI 48170-1272 | |
| (734) 453-9290 | |
| (734) 453-9293 |
| Full Name | Steven J Ceresnie Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 199 N Main St, Plymouth, Michigan |
| Authorized Official Name and Position | Steven J Ceresnie (OWNER) |
| Authorized Official Contact | 7344539290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven J Ceresnie Phd Pc 199 N Main St Plymouth MI 48170-1272 Ph: (734) 453-9290 | Steven J Ceresnie Phd Pc 199 N Main St Plymouth MI 48170-1272 Ph: (734) 453-9290 |
| NPI Number | 1013166578 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 10/27/2008 |
| Medicare PECOS PAC ID | 5698842144 |
|---|---|
| Medicare Enrollment ID | O20080924000669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013166578 | NPI | - | NPPES |
| 620H24558 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 6301002659 (Michigan) | Primary |
| Provider Name | Steven J Ceresnie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942475348 PECOS PAC ID: 5597832378 Enrollment ID: I20080919000345 |
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