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43329 Schoenherr Rd Sterling Heights MI 48313-1959 | |
| (248) 277-5353 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 43329 Schoenherr Rd, Sterling Heights, Michigan |
| Authorized Official Name and Position | Patricia Thaar (CREDENTIALING) |
| Authorized Official Contact | 2482775353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
43329 Schoenherr Rd Sterling Heights MI 48313-1959 Ph: (248) 277-5353 | 43329 Schoenherr Rd Sterling Heights MI 48313-1959 Ph: (248) 277-5353 |
| NPI Number | 1508463126 |
|---|---|
| Provider Enumeration Date | 10/06/2020 |
| Last Update Date | 10/07/2024 |
| Certification Date | 10/07/2024 |
| Medicare PECOS PAC ID | 2668815879 |
|---|---|
| Medicare Enrollment ID | O20240205002719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508463126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Patricia Thaar-tocco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558827279 PECOS PAC ID: 5294179032 Enrollment ID: I20240220002321 |
| Provider Name | Jeannine Marthen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346923067 PECOS PAC ID: 6608212436 Enrollment ID: I20240314002281 |
| Provider Name | Ashley Karas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396874376 PECOS PAC ID: 6901242759 Enrollment ID: I20240314002978 |
| Provider Name | Anne Holtvluwer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003566837 PECOS PAC ID: 8820434681 Enrollment ID: I20240314003322 |
| Provider Name | Diane Marie Johnston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184180465 PECOS PAC ID: 9739525437 Enrollment ID: I20240315001032 |
| Provider Name | Stacie Michalak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942548029 PECOS PAC ID: 4880030535 Enrollment ID: I20240315002868 |
| Provider Name | Amee Briney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912322769 PECOS PAC ID: 4587001334 Enrollment ID: I20240328001391 |
| Provider Name | Tara L Kaszubski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407243215 PECOS PAC ID: 7911447255 Enrollment ID: I20240912002976 |
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