| Carolyn Roath, Pllc | |
|
5505 Star Flower Dr Haslett MI 48840-8695 | |
| (517) 242-4426 | |
| Not Available |
| Full Name | Carolyn Roath, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 5505 Star Flower Dr, Haslett, Michigan |
| Authorized Official Name and Position | Carolyn T Roath (OWNER) |
| Authorized Official Contact | 5172424426 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolyn Roath, Pllc 5505 Star Flower Dr Haslett MI 48840-8695 Ph: (517) 242-4426 | Carolyn Roath, Pllc 5505 Star Flower Dr Haslett MI 48840-8695 Ph: (517) 242-4426 |
| NPI Number | 1235775040 |
|---|---|
| Provider Enumeration Date | 11/27/2019 |
| Last Update Date | 10/29/2023 |
| Certification Date | 10/29/2023 |
| Medicare PECOS PAC ID | 9133506462 |
|---|---|
| Medicare Enrollment ID | O20220506001089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235775040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Carolyn T Roath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487060869 PECOS PAC ID: 5294142063 Enrollment ID: I20210323000114 |
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