| Christine Mushlock, Lmsw Llc | |
|
103 College Ave Se Ste 205 Grand Rapids MI 49503-5945 | |
| (616) 328-9238 | |
| Not Available |
| Full Name | Christine Mushlock, Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 103 College Ave Se Ste 205, Grand Rapids, Michigan |
| Authorized Official Name and Position | Christine Mushlock (OUTPATIENT THERAPIST) |
| Authorized Official Contact | 6163289238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Mushlock, Lmsw Llc 1046 Lake Grove Ave Se East Grand Rapids MI 49506-3556 Ph: (616) 328-9238 | Christine Mushlock, Lmsw Llc 103 College Ave Se Ste 205 Grand Rapids MI 49503-5945 Ph: (616) 328-9238 |
| NPI Number | 1538981501 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 7911428313 |
|---|---|
| Medicare Enrollment ID | O20250228003268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538981501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christine A Mushlock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245578590 PECOS PAC ID: 9638499577 Enrollment ID: I20150518000987 |
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