| Teletherapy Group, Llc | |
|
1111 W Centre Ave Portage MI 49024-5317 | |
| (269) 366-0650 | |
| (269) 762-5957 |
| Full Name | Teletherapy Group, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1111 W Centre Ave, Portage, Michigan |
| Authorized Official Name and Position | Kaitlin Buder (AO) |
| Authorized Official Contact | 2698081818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teletherapy Group, Llc 1111 W Centre Ave Portage MI 49024-5317 Ph: (269) 366-0650 | Teletherapy Group, Llc 1111 W Centre Ave Portage MI 49024-5317 Ph: (269) 366-0650 |
| NPI Number | 1831628379 |
|---|---|
| Provider Enumeration Date | 06/08/2017 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 6800134677 |
|---|---|
| Medicare Enrollment ID | O20190221000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831628379 | NPI | - | NPPES |
| Provider Name | Abbie J Vanderwege |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811296163 PECOS PAC ID: 3870805575 Enrollment ID: I20150709001159 |
| Provider Name | Justice Spearritt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811478639 PECOS PAC ID: 8921408212 Enrollment ID: I20210608001442 |
| Provider Name | Sarah Good |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558686873 PECOS PAC ID: 4880032317 Enrollment ID: I20240403002612 |
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