| Mr Jesse Bacon, MSW | |
|
18303 E 10 Mile Rd Ste 200, Roseville, MI 48066-4989 | |
| (586) 745-0116 | |
| Not Available |
| Full Name | Mr Jesse Bacon |
|---|---|
| Gender | Male |
| Speciality | Social Worker |
| Location | 18303 E 10 Mile Rd Ste 200, Roseville, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548605173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | 6801095708 (Michigan) | Primary |
| Entity Name | Training & Treatment Innovations Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609857978 PECOS PAC ID: 1557323144 Enrollment ID: O20041111000393 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jesse Bacon, MSW 18303 E 10 Mile Rd Ste 200, Roseville, MI 48066-4989 Ph: (586) 745-0116 | Mr Jesse Bacon, MSW 18303 E 10 Mile Rd Ste 200, Roseville, MI 48066-4989 Ph: (586) 745-0116 |
Yvette Mccoy-rodgers, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 18303 E 10 Mile Rd, Roseville, MI 48066 Phone: 586-204-1576 | |
Terri Leonard, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 27730 Brinker St, Roseville, MI 48066 Phone: 586-204-3557 | |
Ms. Diane Gail Russell, M.S.W. Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 25869 Kelly Rd, Suite A, Roseville, MI 48066 Phone: 586-773-6020 Fax: 586-773-6093 | |
Darnisha Sharday Mackey, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 27085 Gratiot Ave Ste 107, Roseville, MI 48066 Phone: 586-285-5361 | |
Ms. Kristen Joy King, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 18223 E 10 Mile Rd Ste 100, Roseville, MI 48066 Phone: 586-778-5880 Fax: 586-778-4362 | |
Lamika Banks, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 27550 Groveland St, Roseville, MI 48066 Phone: 586-213-2837 | |
Mrs. Mary G. Koukios, L.M.S.W. Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 25869 Kelly Rd Ste A, Roseville, MI 48066 Phone: 586-773-6020 Fax: 586-773-6093 |