| Mr Kenneth James Mazur, LMSW | |
|
32401 8 Mile Rd, Livonia, MI 48152-1301 | |
| (248) 991-3868 | |
| Not Available |
| Full Name | Mr Kenneth James Mazur |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 32401 8 Mile Rd, Livonia, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578936324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801060902 (Michigan) | Primary |
| Entity Name | Rochester Evidence-based Psychotherapy Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326580432 PECOS PAC ID: 5496007254 Enrollment ID: O20181008000217 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kenneth James Mazur, LMSW 32401 8 Mile Rd, Livonia, MI 48152-1301 Ph: (248) 991-3868 | Mr Kenneth James Mazur, LMSW 32401 8 Mile Rd, Livonia, MI 48152-1301 Ph: (248) 991-3868 |
Bushra Tayab, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 37450 Schoolcraft Rd Ste 110, Livonia, MI 48150 Phone: 734-458-4601 Fax: 734-458-4611 | |
Robert Keith Graham, DCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 17940 Farmington Rd, Suite 225, Livonia, MI 48152 Phone: 734-466-3311 | |
Kellie Kroeger, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 19805 Farmington Rd, Livonia, MI 48152 Phone: 586-846-0535 | |
Anna Stocker, LLMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16836 Newburgh Rd, Livonia, MI 48154 Phone: 734-464-4220 | |
Rebecca L Sherman, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 17250 Farmington Rd, Livonia, MI 48152 Phone: 734-425-4070 Fax: 734-425-8350 | |
Mrs. Amanda Denise Glaze, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14100 Newburgh Rd, Livonia, MI 48154 Phone: 734-464-7810 | |
Mrs. Cortney Renee Bugar, LLMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 18316 Middlebelt Rd, Livonia, MI 48152 Phone: 248-615-9730 |