| Antoinette Peterson,llc | |
|
147 N Milford Rd Suite 201a Highland MI 48357-4500 | |
| (248) 563-0587 | |
| Not Available |
| Full Name | Antoinette Peterson,llc |
|---|---|
| Speciality | Social Worker |
| Location | 147 N Milford Rd, Highland, Michigan |
| Authorized Official Name and Position | Antoinette Peterson (OWNER) |
| Authorized Official Contact | 2485630587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antoinette Peterson,llc 147 N Milford Rd Ste 201 Highland MI 48357-4500 Ph: (248) 563-0587 | Antoinette Peterson,llc 147 N Milford Rd Suite 201a Highland MI 48357-4500 Ph: (248) 563-0587 |
| NPI Number | 1194050914 |
|---|---|
| Provider Enumeration Date | 10/13/2009 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Medicare PECOS PAC ID | 3072651835 |
|---|---|
| Medicare Enrollment ID | O20091116000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194050914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801061284 (Michigan) | Primary |
| Provider Name | Antoinette Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295975522 PECOS PAC ID: 4183762941 Enrollment ID: I20091116000316 |
| Provider Name | Lynnette S La Brecque |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821269721 PECOS PAC ID: 8729113196 Enrollment ID: I20100324000490 |
| Provider Name | Michelle L Dickinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093041956 PECOS PAC ID: 2365567039 Enrollment ID: I20100917000837 |
| Provider Name | Kathryn J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104286046 PECOS PAC ID: 8426330291 Enrollment ID: I20170131002733 |
| Provider Name | Kelly Lynn O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043734783 PECOS PAC ID: 7012246697 Enrollment ID: I20190906001644 |
| Provider Name | Sarah Bismack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508595745 PECOS PAC ID: 2567838469 Enrollment ID: I20221018001669 |
| Provider Name | Tammie David |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710620059 PECOS PAC ID: 7719353614 Enrollment ID: I20221018001743 |
| Provider Name | Simone Rubio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326540709 PECOS PAC ID: 3971036153 Enrollment ID: I20241025002829 |
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