| A New Hope Counseling Center | |
|
3815 W St Joe St Ste A400 Lansing MI 48917-5600 | |
| (517) 323-4531 | |
| (517) 323-4531 |
| Full Name | A New Hope Counseling Center |
|---|---|
| Speciality | Psychologist |
| Location | 3815 W St Joe St Ste A400, Lansing, Michigan |
| Authorized Official Name and Position | Ronald D Fandrick (TRUSTEE) |
| Authorized Official Contact | 5173234531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A New Hope Counseling Center 3815 W St Joe St Ste A400 Lansing MI 48917-5600 Ph: (517) 323-4531 | A New Hope Counseling Center 3815 W St Joe St Ste A400 Lansing MI 48917-5600 Ph: (517) 323-4531 |
| NPI Number | 1700177227 |
|---|---|
| Provider Enumeration Date | 05/02/2011 |
| Last Update Date | 12/12/2017 |
| Medicare PECOS PAC ID | 0345503819 |
|---|---|
| Medicare Enrollment ID | O20180416000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700177227 | NPI | - | NPPES |
| 68-0-C34663-0 | Other | COMMUNITY BLUE | |
| OC-34663 | Other | MI | BC/BS |
| 262-068-000 | Other | MI | MAGELLAN |
| P26624F | Other | MI | BLUE CARE NETWORK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 630-100-8822 (Michigan) | Primary |
| Provider Name | Ronald D Fandrick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881762250 PECOS PAC ID: 4981967452 Enrollment ID: I20180416000447 |
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