| Authentic Wellness, LLC | |
|
54354 State Highway M203 Hancock MI 49930-9448 | |
| (906) 281-4806 | |
| Not Available |
| Full Name | Authentic Wellness, LLC |
|---|---|
| Speciality | Counselor |
| Location | 54354 State Highway M203, Hancock, Michigan |
| Authorized Official Name and Position | Kelly Niileksela (CO-OWNER) |
| Authorized Official Contact | 9062999355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Wellness, LLC 54354 State Highway M203 Hancock MI 49930-9448 Ph: (906) 281-4806 | Authentic Wellness, LLC 54354 State Highway M203 Hancock MI 49930-9448 Ph: (906) 281-4806 |
| NPI Number | 1396484366 |
|---|---|
| Provider Enumeration Date | 05/30/2022 |
| Last Update Date | 08/06/2023 |
| Certification Date | 08/06/2023 |
| Medicare PECOS PAC ID | 9931555612 |
|---|---|
| Medicare Enrollment ID | O20231101001637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396484366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| Provider Name | Richard Warner Featherly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932232816 PECOS PAC ID: 8729474770 Enrollment ID: I20220331001176 |
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