| Grounded Therapy Network Llc | |
|
301 N Main St Lake City MI 49651-5102 | |
| (231) 295-1196 | |
| Not Available |
| Full Name | Grounded Therapy Network Llc |
|---|---|
| Speciality | Counselor |
| Location | 301 N Main St, Lake City, Michigan |
| Authorized Official Name and Position | Stephen C Wheeler (OWNER) |
| Authorized Official Contact | 6164335046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grounded Therapy Network Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Grounded Therapy Network Llc 301 N Main St Lake City MI 49651-5102 Ph: (231) 295-1196 |
| NPI Number | 1629852462 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Medicare PECOS PAC ID | 9335592419 |
|---|---|
| Medicare Enrollment ID | O20240124004095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629852462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Stephen C. Wheeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366196586 PECOS PAC ID: 0244683324 Enrollment ID: I20240124004166 |
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