| Ann Emilie-clare Smith Psyd Lp P.c. | |
|
195 W 9 Mile Rd Ste 103 Ferndale MI 48220-1749 | |
| (248) 535-2647 | |
| Not Available |
| Full Name | Ann Emilie-clare Smith Psyd Lp P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 195 W 9 Mile Rd Ste 103, Ferndale, Michigan |
| Authorized Official Name and Position | Ann Emilie-clare Smith (PSYCHOLOGIST) |
| Authorized Official Contact | 2485352647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ann Emilie-clare Smith Psyd Lp P.c. 2209 Sunnyknoll Ave Berkley MI 48072-1791 Ph: (248) 535-2647 | Ann Emilie-clare Smith Psyd Lp P.c. 195 W 9 Mile Rd Ste 103 Ferndale MI 48220-1749 Ph: (248) 535-2647 |
| NPI Number | 1174029177 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 03/30/2018 |
| Medicare PECOS PAC ID | 8921362492 |
|---|---|
| Medicare Enrollment ID | O20180509000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174029177 | NPI | - | NPPES |
| 1194943209 | Other | MI | NPI |
| 11819364 | Other | CAQH | |
| 6301013774 | Other | MI | STATE OF MICHIGAN BOARD OF PSYCHOLOGY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301013774 (Michigan) | Primary |
| Provider Name | Ann Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194943209 PECOS PAC ID: 2365527710 Enrollment ID: I20080310000127 |
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