| Third Age Counseling Llc | |
|
2020 Raybrook St Se Ste 203 Grand Rapids MI 49546-7717 | |
| (616) 490-9118 | |
| Not Available |
| Full Name | Third Age Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2020 Raybrook St Se Ste 203, Grand Rapids, Michigan |
| Authorized Official Name and Position | Cheryl A Corcoran (PRINCIPAL) |
| Authorized Official Contact | 6164909118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Third Age Counseling Llc 2020 Raybrook St Se Ste 203 Grand Rapids MI 49546-7717 Ph: () - | Third Age Counseling Llc 2020 Raybrook St Se Ste 203 Grand Rapids MI 49546-7717 Ph: (616) 490-9118 |
| NPI Number | 1598236804 |
|---|---|
| Provider Enumeration Date | 12/12/2018 |
| Last Update Date | 05/21/2019 |
| Medicare PECOS PAC ID | 5092048967 |
|---|---|
| Medicare Enrollment ID | O20190607000808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598236804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cheryl A. Corcoran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770996043 PECOS PAC ID: 2163755034 Enrollment ID: I20190607000960 |
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