The Mindful Self, Llc | |
28303 Dequindre Rd Suite 200 Madison Heights MI 48071-3040 | |
(248) 543-0033 | |
Not Available |
Full Name | The Mindful Self, Llc |
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Speciality | Counselor |
Location | 28303 Dequindre Rd, Madison Heights, Michigan |
Authorized Official Name and Position | Alisa M Hilewsky (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 2485430033 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Mindful Self, Llc 28303 Dequindre Rd Suite 200 Madison Heights MI 48071-3040 Ph: (248) 543-0033 | The Mindful Self, Llc 28303 Dequindre Rd Suite 200 Madison Heights MI 48071-3040 Ph: (248) 543-0033 |
NPI Number | 1477805463 |
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Provider Enumeration Date | 10/15/2012 |
Last Update Date | 10/15/2012 |
Medicare PECOS PAC ID | 1456575711 |
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Medicare Enrollment ID | O20140609000185 |
Identifier | Type | State | Issuer |
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1477805463 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | 6401011013 (Michigan) | Primary |
103T00000X | Psychologist | 6301024395 (Michigan) | Secondary |
Provider Name | Lori A Ruppel |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1568575603 PECOS PAC ID: 8921004300 Enrollment ID: I20061006000383 |
Provider Name | Alisa M Hilewsky |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1407002447 PECOS PAC ID: 3072737337 Enrollment ID: I20161228000444 |
Provider Name | Kelly R Karpowitsch |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588204713 PECOS PAC ID: 5092141879 Enrollment ID: I20200214002234 |
Provider Name | Dana Jeffery |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1669846614 PECOS PAC ID: 1254748924 Enrollment ID: I20210324001806 |
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