Child & Family Psychological Services Of Michigan | |
1662 E Centre Ave Portage MI 49002-4496 | |
(269) 321-8564 | |
Not Available |
Full Name | Child & Family Psychological Services Of Michigan |
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Speciality | Psychologist - Counseling |
Location | 1662 E Centre Ave, Portage, Michigan |
Authorized Official Name and Position | Leslie Johnson (CEO) |
Authorized Official Contact | 7045066267 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Child & Family Psychological Services Of Michigan 11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (269) 321-8564 | Child & Family Psychological Services Of Michigan 1662 E Centre Ave Portage MI 49002-4496 Ph: (269) 321-8564 |
NPI Number | 1922860170 |
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Provider Enumeration Date | 01/24/2024 |
Last Update Date | 03/13/2024 |
Certification Date | 03/13/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922860170 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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