| Wilson And Wynn Interventions, Plc | |
|
4519 Cascade Rd Se Ste 6 Grand Rapids MI 49546-8319 | |
| (616) 647-3460 | |
| Not Available |
| Full Name | Wilson And Wynn Interventions, Plc |
|---|---|
| Speciality | Psychologist |
| Location | 4519 Cascade Rd Se Ste 6, Grand Rapids, Michigan |
| Authorized Official Name and Position | Sandra Jean Wynn-stelt (CO-OWNER) |
| Authorized Official Contact | 6166473460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson And Wynn Interventions, Plc 10843 Crawford Lake Trl Cedar Springs MI 49319-8771 Ph: (616) 647-3460 | Wilson And Wynn Interventions, Plc 4519 Cascade Rd Se Ste 6 Grand Rapids MI 49546-8319 Ph: (616) 647-3460 |
| NPI Number | 1598810137 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0143302935 |
|---|---|
| Medicare Enrollment ID | O20080201000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598810137 | NPI | - | NPPES |
| Provider Name | Jennifer Barabas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669884169 PECOS PAC ID: 6002198942 Enrollment ID: I20170130000054 |
| Provider Name | Victoria L Wilson |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1649208018 PECOS PAC ID: 4587746375 Enrollment ID: I20190815001477 |
| Provider Name | Sandra Jean Wynn-stelt |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1033398581 PECOS PAC ID: 7214019009 Enrollment ID: I20200504000534 |
| Provider Name | Amy Breckon |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1164965877 PECOS PAC ID: 5496166712 Enrollment ID: I20201117003499 |
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