| 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 |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 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 | Cassandra Anne Valeri |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154910586 PECOS PAC ID: 9335552231 Enrollment ID: I20210114001280 |
| Provider Name | Torey M. Mcnally |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1124646310 PECOS PAC ID: 9537563481 Enrollment ID: I20210813002659 |
| Provider Name | Samantha Brindley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275208399 PECOS PAC ID: 0547665135 Enrollment ID: I20210819002028 |
| Provider Name | Victoria Paige Armenio |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1720570310 PECOS PAC ID: 0446644207 Enrollment ID: I20220222001353 |
| Provider Name | Kaylee Marie Gerow |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588395784 PECOS PAC ID: 0244619922 Enrollment ID: I20220627002675 |
| Provider Name | Zosia R Stolarchuk |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821631482 PECOS PAC ID: 8426431636 Enrollment ID: I20220822001753 |
| Provider Name | Vinitha Kodali |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457812760 PECOS PAC ID: 2567795099 Enrollment ID: I20230123001100 |
| Provider Name | Heather R. Dupuis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033305883 PECOS PAC ID: 0840385118 Enrollment ID: I20230427002821 |
| Provider Name | Kayla M Durbin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881308369 PECOS PAC ID: 7517322068 Enrollment ID: I20230505000553 |
| Provider Name | Sarah Carlson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1881398840 PECOS PAC ID: 7911363437 Enrollment ID: I20230525000318 |
| Provider Name | Nicole Kelly |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1629767942 PECOS PAC ID: 9830556117 Enrollment ID: I20230531003130 |
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