Jay Gerald Blazius, | |
47252 Grand Cypress Ct, Macomb, MI 48044-3025 | |
(586) 872-5111 | |
Not Available |
Full Name | Jay Gerald Blazius |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 47252 Grand Cypress Ct, Macomb, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215630025 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6401019077 (Michigan) | Primary |
Entity Name | The Mindful Self Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477805463 PECOS PAC ID: 1456575711 Enrollment ID: O20140609000185 |
Mailing Address | Practice Location Address |
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Jay Gerald Blazius, 47252 Grand Cypress Ct, Macomb, MI 48044-3025 Ph: (586) 872-5111 | Jay Gerald Blazius, 47252 Grand Cypress Ct, Macomb, MI 48044-3025 Ph: (586) 872-5111 |
Lisa C Beauvais, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 49587 Hiddenbrook Dr, Macomb, MI 48042 Phone: 586-612-1631 | |
Latosia Rena-denise Logan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 45964 Brentwood St, Macomb, MI 48042 Phone: 586-948-0665 | |
Jennifer S Laboda, MA LLPC NCC SCL Counselor Medicare: Medicare Enrolled Practice Location: 54583 Joseph Ronald Dr, Macomb, MI 48042 Phone: 586-322-9972 | |
Anna Hickey, Counselor Medicare: Medicare Enrolled Practice Location: 17937 Hall Rd, Macomb, MI 48044 Phone: 586-255-0499 | |
Kathryn Felcyn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 48772 Fairmont Dr, Macomb, MI 48044 Phone: 586-212-5814 | |
Laura Ann Zotos, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 55530 Nile Way, Macomb, MI 48042 Phone: 586-292-5650 | |
Mrs. Michelle L. Siev, LLPC Counselor Medicare: Medicare Enrolled Practice Location: 21400 Dogleg Dr, Macomb, MI 48042 Phone: 586-598-7403 |