| Emotional Advantage Llc | |
|
1603 E 9 Mile Rd Ferndale MI 48220-2065 | |
| (248) 514-4955 | |
| Not Available |
| Full Name | Emotional Advantage Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1603 E 9 Mile Rd, Ferndale, Michigan |
| Authorized Official Name and Position | Anton Babushkin (OWNER) |
| Authorized Official Contact | 2485158873 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional Advantage Llc 1603 E 9 Mile Rd Ferndale MI 48220-2065 Ph: (248) 514-4955 | Emotional Advantage Llc 1603 E 9 Mile Rd Ferndale MI 48220-2065 Ph: (248) 514-4955 |
| NPI Number | 1447647789 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Medicare PECOS PAC ID | 7719208842 |
|---|---|
| Medicare Enrollment ID | O20150602000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447647789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6801089302 (Michigan) | Primary |
| Provider Name | Anton Babushkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992910376 PECOS PAC ID: 1052594629 Enrollment ID: I20110321000490 |
| Provider Name | Claudia Cacciato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184055790 PECOS PAC ID: 1951619956 Enrollment ID: I20150924000965 |
| Provider Name | Michael Timothy Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942774054 PECOS PAC ID: 1557756350 Enrollment ID: I20220314001421 |
| Provider Name | Tami Jo Trea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760132096 PECOS PAC ID: 2860870524 Enrollment ID: I20220608001966 |
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