| Amanda Estill Llc | |
|
119 W Cass St Unit 91 Greenville MI 48838-5003 | |
| (989) 506-4457 | |
| (616) 619-6007 |
| Full Name | Amanda Estill Llc |
|---|---|
| Speciality | Counselor |
| Location | 119 W Cass St Unit 91, Greenville, Michigan |
| Authorized Official Name and Position | Amanda Estill (OWNER/THERAPIST) |
| Authorized Official Contact | 9895064457 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Estill Llc 119 W Cass St Unit 91 Greenville MI 48838-5003 Ph: (989) 506-4457 | Amanda Estill Llc 119 W Cass St Unit 91 Greenville MI 48838-5003 Ph: (989) 506-4457 |
| NPI Number | 1720616766 |
|---|---|
| Provider Enumeration Date | 03/27/2020 |
| Last Update Date | 12/18/2020 |
| Certification Date | 12/18/2020 |
| Medicare PECOS PAC ID | 3577091503 |
|---|---|
| Medicare Enrollment ID | O20250103002353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720616766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nicole A Vega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366971624 PECOS PAC ID: 3072930502 Enrollment ID: I20200826000999 |
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