| Mary Ann Corneliussen, MSW | |
|
2333 Biddle Ave, Wyandotte, MI 48192-4668 | |
| (734) 246-6000 | |
| (734) 246-6986 |
| Full Name | Mary Ann Corneliussen |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 20 Years |
| Location | 2333 Biddle Ave, Wyandotte, 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 |
|---|---|---|---|
| 1366884272 | NPI | - | NPPES |
| 0H21692 | Other | MI | BLUE CROSS |
| 1093940272 | Other | MI | GROUP NPI HENRY FORD WYANDOTTE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801088231 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Michigan Behavioral Medicine Pllc | 8325069305 | 22 |
| Entity Name | Henry Ford Wyandotte Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093940272 PECOS PAC ID: 2264334499 Enrollment ID: O20040316000717 |
| Entity Name | Michigan Behavioral Medicine Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144317116 PECOS PAC ID: 8325069305 Enrollment ID: O20051219000372 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann Corneliussen, MSW 1640 Fort St, Ste D Attn Denise, Trenton, MI 48183-2040 Ph: (734) 391-3057 | Mary Ann Corneliussen, MSW 2333 Biddle Ave, Wyandotte, MI 48192-4668 Ph: (734) 246-6000 |
Kathryn A Branson, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2300 Biddle Ave Ste 100, Wyandotte, MI 48192 Phone: 734-246-5705 Fax: 734-246-5750 | |
Susan Mahalik, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2514 Biddle Ave, Wyandotte, MI 48192 Phone: 517-775-4248 Fax: 734-282-2215 | |
Dianne Marie Stachel, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 | |
Amanda Fritz, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 Maple St Ste 215, Wyandotte, MI 48192 Phone: 734-288-8161 | |
Nancy Sherry, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 Fax: 734-246-6990 | |
Shaun Douglas Lowery, LLMSW, MDIV Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-287-1382 Fax: 734-418-3911 |