Clinton Counseling Center | |
2 Crocker Blvd Ste 205 Mount Clemens MI 48043-2558 | |
(586) 463-7079 | |
(586) 468-4505 |
Full Name | Clinton Counseling Center |
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Speciality | Community/Behavioral Health |
Location | 2 Crocker Blvd Ste 205, Mount Clemens, Michigan |
Authorized Official Name and Position | Jeffrey Alan Oldham (CEO) |
Authorized Official Contact | 5864637079 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clinton Counseling Center 2 Crocker Boulevard Suite 103 Mt Clemens MI 48043-2558 Ph: (586) 463-7079 | Clinton Counseling Center 2 Crocker Blvd Ste 205 Mount Clemens MI 48043-2558 Ph: (586) 463-7079 |
NPI Number | 1750400065 |
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Provider Enumeration Date | 03/28/2007 |
Last Update Date | 03/08/2023 |
Certification Date | 03/08/2023 |
Medicare PECOS PAC ID | 8022045418 |
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Medicare Enrollment ID | O20050718000480 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750400065 | NPI | - | NPPES |
125582 | Other | VALUE OPTIONS | |
20476 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 500017 (Michigan) | Primary |
Provider Name | Kathleen A Allin |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1013085984 PECOS PAC ID: 6002918331 Enrollment ID: I20070216000411 |
Provider Name | Neda Habeeb |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1831548536 PECOS PAC ID: 2567753585 Enrollment ID: I20190826000260 |
Provider Name | Wendy Besler |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1962699736 PECOS PAC ID: 7012290679 Enrollment ID: I20220209002158 |
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