| Tanya Douglas, | |
|
611 N State St, Stanton, MI 48888-9702 | |
| (989) 831-7520 | |
| (989) 831-7578 |
| Full Name | Tanya Douglas |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 9 Years |
| Location | 611 N State St, Stanton, 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 |
|---|---|---|---|
| 1285183053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kimberly B Lavender, Llc | 5193048833 | 3 |
| Entity Name | Kimberly B Lavender, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548667397 PECOS PAC ID: 5193048833 Enrollment ID: O20150102001378 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya Douglas, 611 N State St, Stanton, MI 48888-9702 Ph: (989) 831-7520 | Tanya Douglas, 611 N State St, Stanton, MI 48888-9702 Ph: (989) 831-7520 |
Jennifer Marie Bauer, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7520 Fax: 989-831-7578 | |
Nicole Alexander, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7520 Fax: 989-831-7578 | |
Julianna Marie Kozara, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7520 Fax: 989-831-7578 | |
Allyssa Nicole Martineau, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7620 Fax: 989-831-7578 | |
Aubrie Thornton, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7520 | |
Linda Marie Norkey, LPC, CAAC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 611 N State St, Stanton, MI 48888 Phone: 989-831-7520 Fax: 989-831-7578 |