| Telebehavioral Health.us | |
|
1959 Thornapple River Dr Se Grand Rapids MI 49546-9706 | |
| (616) 327-2405 | |
| (616) 259-4214 |
| Full Name | Telebehavioral Health.us |
|---|---|
| Speciality | Social Worker |
| Location | 1959 Thornapple River Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Susan Emily Morozowich (CEO) |
| Authorized Official Contact | 6163272405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telebehavioral Health.us Po Box 609 Ada MI 49301-0609 Ph: (616) 327-2405 | Telebehavioral Health.us 1959 Thornapple River Dr Se Grand Rapids MI 49546-9706 Ph: (616) 327-2405 |
| NPI Number | 1194252692 |
|---|---|
| Provider Enumeration Date | 05/15/2017 |
| Last Update Date | 10/15/2022 |
| Certification Date | 10/15/2022 |
| Medicare PECOS PAC ID | 9537409701 |
|---|---|
| Medicare Enrollment ID | O20190326001153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194252692 | NPI | - | NPPES |
| 1548434020 | Medicaid | MI | |
| 1194252692 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sharon Lee Vantuyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669873188 PECOS PAC ID: 6608855515 Enrollment ID: I20040715000197 |
| Provider Name | Stephanie Lagalo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811924715 PECOS PAC ID: 7315959814 Enrollment ID: I20060627000389 |
| Provider Name | Susan Morozowich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548434020 PECOS PAC ID: 6002942208 Enrollment ID: I20100326000608 |
| Provider Name | Rachel L Boots-rositas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740513126 PECOS PAC ID: 8729224795 Enrollment ID: I20130417000330 |
| Provider Name | Erin Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528457322 PECOS PAC ID: 3274850052 Enrollment ID: I20150317001062 |
| Provider Name | Trisha M Waun |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629218698 PECOS PAC ID: 7315273398 Enrollment ID: I20190729003380 |
| Provider Name | Amy Mansfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952745069 PECOS PAC ID: 0749602183 Enrollment ID: I20200612000556 |
| Provider Name | Katelyn Britenriker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184298812 PECOS PAC ID: 5890194427 Enrollment ID: I20210601001817 |
| Provider Name | Elizabeth Anne Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932862794 PECOS PAC ID: 8123417839 Enrollment ID: I20211118002617 |
| Provider Name | Nicholas Tock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558896506 PECOS PAC ID: 2466830187 Enrollment ID: I20240127000249 |
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