Willow Path Counseling Services | |
5725 Venture Park Dr Ste B Kalamazoo MI 49009-2816 | |
(269) 355-0725 | |
Not Available |
Full Name | Willow Path Counseling Services |
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Speciality | Community/Behavioral Health |
Location | 5725 Venture Park Dr Ste B, Kalamazoo, Michigan |
Authorized Official Name and Position | Stacey Fox (OWNER) |
Authorized Official Contact | 2693550725 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Willow Path Counseling Services 5725 Venture Park Dr Ste B Kalamazoo MI 49009-2816 Ph: (269) 355-0725 | Willow Path Counseling Services 5725 Venture Park Dr Ste B Kalamazoo MI 49009-2816 Ph: (269) 355-0725 |
NPI Number | 1568997054 |
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Provider Enumeration Date | 04/22/2017 |
Last Update Date | 06/04/2024 |
Certification Date | 06/04/2024 |
Medicare PECOS PAC ID | 2163791146 |
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Medicare Enrollment ID | O20170706002915 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568997054 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 6801091193 (Michigan) | Primary |
Provider Name | Debra A Broughman |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831226216 PECOS PAC ID: 3678626124 Enrollment ID: I20090730000249 |
Provider Name | Robert Swiatek |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841526530 PECOS PAC ID: 9739210592 Enrollment ID: I20100623000750 |
Provider Name | Stacey S Fox |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952674699 PECOS PAC ID: 9537392006 Enrollment ID: I20140507002127 |
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