| Beachwalk Counseling Llc | |
|
31119 Beachwalk Dr Apt 406 Novi MI 48377-1444 | |
| (313) 737-0164 | |
| Not Available |
| Full Name | Beachwalk Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 31119 Beachwalk Dr Apt 406, Novi, Michigan |
| Authorized Official Name and Position | Kathleen Enersen (OWNER) |
| Authorized Official Contact | 3137370164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beachwalk Counseling Llc 221 W Lake Lansing Rd Ste 200 East Lansing MI 48823-8661 Ph: (313) 737-0164 | Beachwalk Counseling Llc 31119 Beachwalk Dr Apt 406 Novi MI 48377-1444 Ph: (313) 737-0164 |
| NPI Number | 1295544294 |
|---|---|
| Provider Enumeration Date | 01/03/2025 |
| Last Update Date | 01/03/2025 |
| Certification Date | 01/03/2025 |
| Medicare PECOS PAC ID | 4385173194 |
|---|---|
| Medicare Enrollment ID | O20250123002193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295544294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kathleen C Enersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154797322 PECOS PAC ID: 6002236270 Enrollment ID: I20201009001547 |
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