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1725 Pinecrest Dr Ferndale MI 48220-1624 | |
| (248) 289-3109 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1725 Pinecrest Dr, Ferndale, Michigan |
| Authorized Official Name and Position | Daniel Kotsias (OWNER) |
| Authorized Official Contact | 8476649593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
25223 Prairie Dr Southfield MI 48075-2076 Ph: (847) 664-9593 | 1725 Pinecrest Dr Ferndale MI 48220-1624 Ph: (248) 289-3109 |
| NPI Number | 1326699604 |
|---|---|
| Provider Enumeration Date | 09/26/2019 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 2567825300 |
|---|---|
| Medicare Enrollment ID | O20230828002160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326699604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Daniel Kotsias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083126437 PECOS PAC ID: 8325471790 Enrollment ID: I20191126001453 |
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