| Crossroads Psychological Center Pllc | |
|
106 N Antler St Gladwin MI 48624-1562 | |
| (989) 709-5430 | |
| (989) 403-7161 |
| Full Name | Crossroads Psychological Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 106 N Antler St, Gladwin, Michigan |
| Authorized Official Name and Position | Debra Hamilton (OWNER) |
| Authorized Official Contact | 9897095430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Psychological Center Pllc 106 N Antler St Gladwin MI 48624-1562 Ph: (989) 709-5430 | Crossroads Psychological Center Pllc 106 N Antler St Gladwin MI 48624-1562 Ph: (989) 709-5430 |
| NPI Number | 1346790375 |
|---|---|
| Provider Enumeration Date | 10/13/2016 |
| Last Update Date | 06/05/2024 |
| Certification Date | 06/05/2024 |
| Medicare PECOS PAC ID | 6002177607 |
|---|---|
| Medicare Enrollment ID | O20180222000813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346790375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Debra Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164954129 PECOS PAC ID: 1355604307 Enrollment ID: I20180404002619 |
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