| Chad Thomas Bousamra, MA | |
|
1105 E Eighth St, Traverse City, MI 49686-2936 | |
| (231) 935-6787 | |
| (231) 935-6920 |
| Full Name | Chad Thomas Bousamra |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 18 Years |
| Location | 1105 E Eighth St, Traverse City, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164694030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 6401010758 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Medical Center | Traverse city, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Medical Center | 3072426287 | 345 |
| Entity Name | Munson Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083761860 PECOS PAC ID: 3072426287 Enrollment ID: O20040108000904 |
| Entity Name | Munson Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386672665 PECOS PAC ID: 3072426287 Enrollment ID: O20040816000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Chad Thomas Bousamra, MA 1105 E Eighth St, Traverse City, MI 49686-2936 Ph: (231) 935-6787 | Chad Thomas Bousamra, MA 1105 E Eighth St, Traverse City, MI 49686-2936 Ph: (231) 935-6787 |
Kimberly Manrique, M.S, L.P.C., A.T.R Counselor Medicare: Not Enrolled in Medicare Practice Location: 5798 Deer Trail Dr, Traverse City, MI 49684 Phone: 231-709-3177 | |
Breanne Ashly Pedersen, Counselor Medicare: Accepting Medicare Assignments Practice Location: 3298 Veterans Dr Ste 1, Traverse City, MI 49684 Phone: 231-715-8466 Fax: 231-943-2263 | |
Ms. Angela Lynn Merriman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1844 Oak Hollow Dr Ste B, Traverse City, MI 49686 Phone: 231-714-0282 | |
Deanne R Briggs, LPC, CAC III Counselor Medicare: Accepting Medicare Assignments Practice Location: 1105 Sixth St, Traverse City, MI 49684 Phone: 231-935-6380 Fax: 231-935-6920 | |
Amanda Gillis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3155 Logan Valley Rd, Traverse City, MI 49684 Phone: 989-954-4673 | |
Mrs. Emily Knapp, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7150 Lake Leelanau Dr, Traverse City, MI 49684 Phone: 231-649-2126 | |
Terry Gorton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 116 E 8th St, Traverse City, MI 49684 Phone: 231-346-5221 Fax: 231-922-2095 |