| Center For Integrated Health And Well-being, P.c. | |
|
221 S Main St Ste 201 Royal Oak MI 48067-2653 | |
| (248) 398-7574 | |
| (248) 398-6265 |
| Full Name | Center For Integrated Health And Well-being, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 221 S Main St Ste 201, Royal Oak, Michigan |
| Authorized Official Name and Position | Gregory Michael Kotlarz (OWNER/LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2483987574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Integrated Health And Well-being, P.c. 221 S Main St Ste 201 Royal Oak MI 48067-2653 Ph: (248) 398-7574 | Center For Integrated Health And Well-being, P.c. 221 S Main St Ste 201 Royal Oak MI 48067-2653 Ph: (248) 398-7574 |
| NPI Number | 1073242632 |
|---|---|
| Provider Enumeration Date | 06/08/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 9739562489 |
|---|---|
| Medicare Enrollment ID | O20220813000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073242632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0004X | Psychologist - Health | (* (Not Available)) | Primary |
| Provider Name | Gregory M Kotlarz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134160732 PECOS PAC ID: 3476467366 Enrollment ID: I20040108000309 |
| Provider Name | Patricia M Imai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699225722 PECOS PAC ID: 5799063939 Enrollment ID: I20161024000922 |
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