| Transcendent Bodhi Psychotherapy Llc | |
|
8061 21 Mile Rd Ste 2 Shelby Twp MI 48317-4309 | |
| (586) 943-0028 | |
| Not Available |
| Full Name | Transcendent Bodhi Psychotherapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 8061 21 Mile Rd Ste 2, Shelby Twp, Michigan |
| Authorized Official Name and Position | Candice Ericksen (OWNER) |
| Authorized Official Contact | 5869430028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transcendent Bodhi Psychotherapy Llc 8061 21 Mile Rd Ste 2 Shelby Twp MI 48317-4309 Ph: (586) 943-0028 | Transcendent Bodhi Psychotherapy Llc 8061 21 Mile Rd Ste 2 Shelby Twp MI 48317-4309 Ph: (586) 943-0028 |
| NPI Number | 1922727973 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 08/23/2022 |
| Certification Date | 08/23/2022 |
| Medicare PECOS PAC ID | 7315387511 |
|---|---|
| Medicare Enrollment ID | O20240506001057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922727973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Candice Ericksen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730745266 PECOS PAC ID: 0042650244 Enrollment ID: I20240506001130 |
| Provider Name | Toshia Kole-james |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336854652 PECOS PAC ID: 8022450907 Enrollment ID: I20240523001038 |
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