| J Flack Psyd Pc | |
|
127 N River St Fenton MI 48430-3800 | |
| (810) 309-9355 | |
| Not Available |
| Full Name | J Flack Psyd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 127 N River St, Fenton, Michigan |
| Authorized Official Name and Position | Jennifer Flack (PRESIDENT) |
| Authorized Official Contact | 8103099355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J Flack Psyd Pc 127 N River St Fenton MI 48430-3800 Ph: (810) 309-9355 | J Flack Psyd Pc 127 N River St Fenton MI 48430-3800 Ph: (810) 309-9355 |
| NPI Number | 1770859001 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 01/22/2025 |
| Certification Date | 01/22/2025 |
| Medicare PECOS PAC ID | 0547426264 |
|---|---|
| Medicare Enrollment ID | O20120725000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770859001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 6401006094 (Michigan) | Secondary |
| 104100000X | Social Worker | 6801006671 (Michigan) | Secondary |
| 103T00000X | Psychologist | 6301014240 (Michigan) | Primary |
| Provider Name | Hugh U Armbruster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821034638 PECOS PAC ID: 9830112465 Enrollment ID: I20060110000820 |
| Provider Name | Jennifer F Thelen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821221631 PECOS PAC ID: 5799953428 Enrollment ID: I20110722000322 |
| Provider Name | Pamela L July |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346590858 PECOS PAC ID: 7911156039 Enrollment ID: I20121005000186 |
| Provider Name | Kelly A Gamache |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881086346 PECOS PAC ID: 0345567301 Enrollment ID: I20150401000103 |
| Provider Name | Deanna I Savage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245697317 PECOS PAC ID: 3375847700 Enrollment ID: I20160205000615 |
| Provider Name | Nancy Armbruster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922328996 PECOS PAC ID: 8729324553 Enrollment ID: I20190115001808 |
| Provider Name | Andrea Lynn Mcmanamon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912312653 PECOS PAC ID: 8224486436 Enrollment ID: I20231129000901 |
| Provider Name | Jennifer Beth Mannino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528793684 PECOS PAC ID: 8325490030 Enrollment ID: I20240118001955 |
| Provider Name | Benjamin Michael Meredith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871880807 PECOS PAC ID: 0749626422 Enrollment ID: I20240316000288 |
| Provider Name | Julie Farman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396322616 PECOS PAC ID: 3173932142 Enrollment ID: I20240401001257 |
| Provider Name | Jane Elizabeth Leipold Dika |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093049561 PECOS PAC ID: 7618419490 Enrollment ID: I20240607002065 |
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