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5030 Northwind Dr Ste 108 East Lansing MI 48823-5034 | |
| (517) 336-4335 | |
| (517) 336-0101 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 5030 Northwind Dr Ste 108, East Lansing, Michigan |
| Authorized Official Name and Position | Karen Massoll (PRESIDENT) |
| Authorized Official Contact | 5173364335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1031 E Saginaw St Lansing MI 48906-5519 Ph: (517) 487-9642 | 5030 Northwind Dr Ste 108 East Lansing MI 48823-5034 Ph: (517) 336-4335 |
| NPI Number | 1154421824 |
|---|---|
| Provider Enumeration Date | 09/23/2006 |
| Last Update Date | 09/20/2013 |
| Medicare PECOS PAC ID | 8628248119 |
|---|---|
| Medicare Enrollment ID | O20110818000485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154421824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Linda L Lawrence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124312525 PECOS PAC ID: 2769652809 Enrollment ID: I20110830000052 |
| Provider Name | Jean M Richman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386949097 PECOS PAC ID: 8426216623 Enrollment ID: I20120220000437 |
| Provider Name | Leslie Jane Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245669530 PECOS PAC ID: 2769729342 Enrollment ID: I20190122001245 |
| Provider Name | Linda Wychers-caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164956025 PECOS PAC ID: 9638578552 Enrollment ID: I20210526001950 |
| Provider Name | Karen J Massoll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124128897 PECOS PAC ID: 7416127907 Enrollment ID: I20240118002651 |
| Provider Name | John D Mcphail |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811089923 PECOS PAC ID: 4183094253 Enrollment ID: I20240118002714 |
| Provider Name | Amy Catherine Bolkcom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609587930 PECOS PAC ID: 3375987134 Enrollment ID: I20240220002522 |
| Provider Name | Jamie Neuenschwander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730689753 PECOS PAC ID: 7517404585 Enrollment ID: I20240808000755 |
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