| Bluestone Childrens Center, Llc | |
|
38935 Ann Arbor Rd Livonia MI 48150-3397 | |
| (248) 886-9540 | |
| (248) 254-6613 |
| Full Name | Bluestone Childrens Center, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 38935 Ann Arbor Rd, Livonia, Michigan |
| Authorized Official Name and Position | Jan Greulich (AUTHORIZED OFFICIAL/ MANAGER) |
| Authorized Official Contact | 3139008009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluestone Childrens Center, Llc 38935 Ann Arbor Rd Ste 150 Livonia MI 48150-3397 Ph: (248) 886-9540 | Bluestone Childrens Center, Llc 38935 Ann Arbor Rd Livonia MI 48150-3397 Ph: (248) 886-9540 |
| NPI Number | 1841781531 |
|---|---|
| Provider Enumeration Date | 05/29/2018 |
| Last Update Date | 08/30/2023 |
| Certification Date | 07/31/2023 |
| Medicare PECOS PAC ID | 8325375561 |
|---|---|
| Medicare Enrollment ID | O20190809001477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841781531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| Provider Name | Kelly Luczak |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871062943 PECOS PAC ID: 7416383369 Enrollment ID: I20200212002128 |
| Provider Name | Logan Humitz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528604485 PECOS PAC ID: 4981029683 Enrollment ID: I20200728003418 |
| Provider Name | Malaika L Worsham |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720528581 PECOS PAC ID: 0446669683 Enrollment ID: I20210429001527 |
| Provider Name | Kristina Marie Andonisio |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1093552168 PECOS PAC ID: 1254879539 Enrollment ID: I20240817000622 |
| Provider Name | Madison Margaret Kenrick |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730860511 PECOS PAC ID: 9032657333 Enrollment ID: I20240819000479 |
| Provider Name | Alyssa Marie Spencer |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154163046 PECOS PAC ID: 5294275855 Enrollment ID: I20240910001644 |
| Provider Name | Abigail M Voight |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912732694 PECOS PAC ID: 7113458472 Enrollment ID: I20240927001478 |
Victor M. Cruz Md, P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 17177 N Laurel Park Dr, Suite 131, Livonia, MI 48152 Phone: 734-462-3210 Fax: 734-462-1024 | |
C. Victoria Harrington, Acsw, Plc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 37799 Professional Center Dr, Suite 106, Livonia, MI 48154 Phone: 248-349-8934 | |
Hope Link, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18315 Queensbury Dr, Livonia, MI 48152 Phone: 248-559-1990 | |
Lmh Group Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 39293 Plymouth Rd Ste 117, Livonia, MI 48150 Phone: 734-494-0566 | |
Luis Pomodoro M D Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15645 Farmington Rd, Livonia, MI 48154 Phone: 734-425-5320 Fax: 734-425-6212 | |
St Mary Mercy Physician Practices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 37595 7 Mile Rd Ste 230, Livonia, MI 48152 Phone: 734-743-4540 Fax: 734-743-4541 | |
Goscicki Psychotherapy Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 39325 Plymouth Rd Ste 201, Livonia, MI 48150 Phone: 248-954-4837 |