| Collaborative Change Therapy Services | |
|
302 N Huron St Ypsilanti MI 48197-2947 | |
| (734) 203-0020 | |
| (734) 773-1611 |
| Full Name | Collaborative Change Therapy Services |
|---|---|
| Speciality | Counselor |
| Location | 302 N Huron St, Ypsilanti, Michigan |
| Authorized Official Name and Position | Hannah Rachel Hyde (OWNER) |
| Authorized Official Contact | 7342030020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Change Therapy Services 302 N Huron St Ypsilanti MI 48197-2947 Ph: (734) 203-0020 | Collaborative Change Therapy Services 302 N Huron St Ypsilanti MI 48197-2947 Ph: (734) 203-0020 |
| NPI Number | 1629675889 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Medicare PECOS PAC ID | 4880166867 |
|---|---|
| Medicare Enrollment ID | O20260611000730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629675889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Primary |
| Provider Name | Hannah Hyde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154699874 PECOS PAC ID: 6709359318 Enrollment ID: I20260625001516 |
| Provider Name | Anne Joy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811523277 PECOS PAC ID: 4880167493 Enrollment ID: I20260625001616 |
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