| Circle Of Hope Php Pllc | |
|
9171 Lapeer Rd Ste 200 Davison MI 48423-3617 | |
| (810) 214-1750 | |
| Not Available |
| Full Name | Circle Of Hope Php Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9171 Lapeer Rd Ste 200, Davison, Michigan |
| Authorized Official Name and Position | Angela Liebenthal (FORMER MANAGER) |
| Authorized Official Contact | 8103918921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Circle Of Hope Php Pllc 9171 Lapeer Rd Ste 200 Davison MI 48423-3617 Ph: () - | Circle Of Hope Php Pllc 9171 Lapeer Rd Ste 200 Davison MI 48423-3617 Ph: (810) 214-1750 |
| NPI Number | 1407502842 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Medicare PECOS PAC ID | 9032505128 |
|---|---|
| Medicare Enrollment ID | O20220329000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407502842 | NPI | - | NPPES |
| Provider Name | Mohammad Jafferany |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811008139 PECOS PAC ID: 9234217423 Enrollment ID: I20080429000566 |
| Provider Name | Angela Kay Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386396638 PECOS PAC ID: 5597132753 Enrollment ID: I20221101003067 |
| Provider Name | Tanya Roe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164852430 PECOS PAC ID: 6901279611 Enrollment ID: I20230228001844 |
| Provider Name | Alicia Guzman Pace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619750155 PECOS PAC ID: 9931562881 Enrollment ID: I20230825001223 |
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