| Krystin Mitch, | |
|
38351 Hazel St, Harrison Township, MI 48045-3566 | |
| (586) 630-9675 | |
| Not Available |
| Full Name | Krystin Mitch |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 14 Years |
| Location | 38351 Hazel St, Harrison Township, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295503795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801104157 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeside Professional Counseling Pc | 8729483078 | 8 |
| Entity Name | Lakeside Professional Counseling Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073084083 PECOS PAC ID: 8729483078 Enrollment ID: O20210824003131 |
| Mailing Address | Practice Location Address |
|---|---|
| Krystin Mitch, 38351 Hazel St, Harrison Township, MI 48045-3566 Ph: (586) 630-9675 | Krystin Mitch, 38351 Hazel St, Harrison Township, MI 48045-3566 Ph: (586) 630-9675 |
Andrea Angela Owens-pariseau, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 27621 Wisteria St, Harrison Township, MI 48045 Phone: 810-335-4599 | |
Jennifer Renae Kljajic, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 39031 Canterbury Dr, Harrison Township, MI 48045 Phone: 312-550-1245 | |
Audrey Rosemary Gallas, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 36340 Union Lake Rd Apt 201, Harrison Township, MI 48045 Phone: 251-648-1944 |