| Susan Missad Counseling | |
|
4829 E Beltline Ave Ne Grand Rapids MI 49525-9747 | |
| (616) 291-6595 | |
| Not Available |
| Full Name | Susan Missad Counseling |
|---|---|
| Speciality | Psychologist |
| Location | 4829 E Beltline Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Susan Missad (OWNER) |
| Authorized Official Contact | 6162916595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Missad Counseling 4829 E Beltline Ave Ne Grand Rapids MI 49525-9747 Ph: () - | Susan Missad Counseling 4829 E Beltline Ave Ne Grand Rapids MI 49525-9747 Ph: (616) 291-6595 |
| NPI Number | 1205396538 |
|---|---|
| Provider Enumeration Date | 03/22/2019 |
| Last Update Date | 04/29/2019 |
| Medicare PECOS PAC ID | 3779978960 |
|---|---|
| Medicare Enrollment ID | O20220325001088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205396538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Susan Missad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376058453 PECOS PAC ID: 4688069875 Enrollment ID: I20220325001151 |
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