| Creative Resilience Therapy Services Llc | |
|
8005 Main St Ste 3 Dexter MI 48130-1027 | |
| (734) 489-9686 | |
| Not Available |
| Full Name | Creative Resilience Therapy Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 8005 Main St Ste 3, Dexter, Michigan |
| Authorized Official Name and Position | Halene Waytes (OWNER) |
| Authorized Official Contact | 5176483744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Resilience Therapy Services Llc 8005 Main St Ste 3 Dexter MI 48130-1027 Ph: () - | Creative Resilience Therapy Services Llc 8005 Main St Ste 3 Dexter MI 48130-1027 Ph: (734) 489-9686 |
| NPI Number | 1063007722 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 01/16/2024 |
| Certification Date | 01/16/2024 |
| Medicare PECOS PAC ID | 7315399524 |
|---|---|
| Medicare Enrollment ID | O20240123002840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063007722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Halene Waytes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346697778 PECOS PAC ID: 9133571342 Enrollment ID: I20240123003133 |
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