Therapy Kalamazoo Pllc | |
3503 Greenleaf Blvd Ste 102 Kalamazoo MI 49008-2580 | |
(269) 815-6377 | |
Not Available |
Full Name | Therapy Kalamazoo Pllc |
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Speciality | Social Worker |
Location | 3503 Greenleaf Blvd Ste 102, Kalamazoo, Michigan |
Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
Authorized Official Contact | 5176769797 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Therapy Kalamazoo Pllc 447 Treasure Island Dr Mattawan MI 49071-9470 Ph: (269) 815-6377 | Therapy Kalamazoo Pllc 3503 Greenleaf Blvd Ste 102 Kalamazoo MI 49008-2580 Ph: (269) 815-6377 |
NPI Number | 1598375594 |
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Provider Enumeration Date | 08/04/2020 |
Last Update Date | 11/22/2022 |
Certification Date | 11/22/2022 |
Medicare PECOS PAC ID | 5698190577 |
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Medicare Enrollment ID | O20200810001569 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598375594 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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104100000X | Social Worker | (* (Not Available)) | Primary |
Provider Name | Simone Riggs |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033462338 PECOS PAC ID: 6406178300 Enrollment ID: I20141204000141 |
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