| West Michigan Support And Consultation Pllc | |
|
10854 North Ct Allendale MI 49401-9773 | |
| (616) 430-2826 | |
| Not Available |
| Full Name | West Michigan Support And Consultation Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 10854 North Ct, Allendale, Michigan |
| Authorized Official Name and Position | Michael R Goldsmith (SOLE MEMBER) |
| Authorized Official Contact | 6164302826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Michigan Support And Consultation Pllc 10854 North Ct Allendale MI 49401-9773 Ph: (616) 430-2826 | West Michigan Support And Consultation Pllc 10854 North Ct Allendale MI 49401-9773 Ph: (616) 430-2826 |
| NPI Number | 1518393313 |
|---|---|
| Provider Enumeration Date | 09/25/2013 |
| Last Update Date | 09/25/2013 |
| Medicare PECOS PAC ID | 8022246404 |
|---|---|
| Medicare Enrollment ID | O20140109001243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518393313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801090255 (Michigan) | Primary |
| Provider Name | Michael Goldsmith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376847582 PECOS PAC ID: 6305021171 Enrollment ID: I20110421000597 |
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