| Crucial Moments Therapy Llc | |
|
1750 E Grand River Ave Ste 101 East Lansing MI 48823-4958 | |
| (269) 213-9426 | |
| Not Available |
| Full Name | Crucial Moments Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 1750 E Grand River Ave Ste 101, East Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crucial Moments Therapy Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Crucial Moments Therapy Llc 1750 E Grand River Ave Ste 101 East Lansing MI 48823-4958 Ph: (269) 213-9426 |
| NPI Number | 1114584406 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 08/30/2023 |
| Certification Date | 08/30/2023 |
| Medicare PECOS PAC ID | 7517319908 |
|---|---|
| Medicare Enrollment ID | O20240122002952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114584406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Terry Witherspoon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679975346 PECOS PAC ID: 8426400813 Enrollment ID: I20240122002996 |
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