| Ypsi Arbor Counseling, Llc | |
|
1204 Kingwood St Ypsilanti MI 48197-2142 | |
| (734) 531-8044 | |
| Not Available |
| Full Name | Ypsi Arbor Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1204 Kingwood St, Ypsilanti, Michigan |
| Authorized Official Name and Position | Lauren Keough (OWNER) |
| Authorized Official Contact | 7345318044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ypsi Arbor Counseling, Llc 9905 S Hazel St South Lyon MI 48178-9007 Ph: (734) 531-8044 | Ypsi Arbor Counseling, Llc 1204 Kingwood St Ypsilanti MI 48197-2142 Ph: (734) 531-8044 |
| NPI Number | 1396315305 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 07/03/2021 |
| Certification Date | 07/03/2021 |
| Medicare PECOS PAC ID | 6608264759 |
|---|---|
| Medicare Enrollment ID | O20211022001462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396315305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lauren Keough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376166470 PECOS PAC ID: 0345661062 Enrollment ID: I20200605000384 |
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