| Aspen Psychotherapy Pllc | |
|
1011 W Maple St Ste 150 Kalamazoo MI 49008-5805 | |
| (269) 224-2559 | |
| Not Available |
| Full Name | Aspen Psychotherapy Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1011 W Maple St Ste 150, Kalamazoo, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Psychotherapy Pllc Po Box 10 Mason MI 48854-0010 Ph: () - | Aspen Psychotherapy Pllc 1011 W Maple St Ste 150 Kalamazoo MI 49008-5805 Ph: (269) 224-2559 |
| NPI Number | 1083238703 |
|---|---|
| Provider Enumeration Date | 05/29/2020 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Medicare PECOS PAC ID | 9931522273 |
|---|---|
| Medicare Enrollment ID | O20200706001568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083238703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa Therese Heinrich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841763166 PECOS PAC ID: 1759704091 Enrollment ID: I20200706001651 |
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