| Waves Of Change, Llc | |
|
2017 4th St Jackson MI 49203-4572 | |
| (517) 581-4886 | |
| (517) 905-6046 |
| Full Name | Waves Of Change, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2017 4th St, Jackson, Michigan |
| Authorized Official Name and Position | Amber Joy Norwood (OWNER, THERAPIST) |
| Authorized Official Contact | 5175814886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waves Of Change, Llc 7625 King Rd Spring Arbor MI 49283-9777 Ph: (517) 581-4886 | Waves Of Change, Llc 2017 4th St Jackson MI 49203-4572 Ph: (517) 581-4886 |
| NPI Number | 1194177675 |
|---|---|
| Provider Enumeration Date | 07/07/2016 |
| Last Update Date | 08/24/2020 |
| Certification Date | 08/24/2020 |
| Medicare PECOS PAC ID | 1557655990 |
|---|---|
| Medicare Enrollment ID | O20160809000610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194177675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801094168 (Michigan) | Primary |
| Provider Name | Amber J Norwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073956710 PECOS PAC ID: 7214243047 Enrollment ID: I20150825003421 |
| Provider Name | Lauren Alexandria Colip |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922656826 PECOS PAC ID: 6800288358 Enrollment ID: I20220113002081 |
| Provider Name | Jennifer J Fitch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417335076 PECOS PAC ID: 0042691396 Enrollment ID: I20220718001398 |
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