| Growth Works, Inc | |
|
271 S Main Street Plymouth MI 48170 | |
| (734) 455-4095 | |
| (734) 455-1254 |
| Full Name | Growth Works, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 271 S Main Street, Plymouth, Michigan |
| Authorized Official Name and Position | R Scott Levely (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7344554095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth Works, Inc 271 S Main Street Plymouth MI 48170 Ph: (734) 455-4095 | Growth Works, Inc 271 S Main Street Plymouth MI 48170 Ph: (734) 455-4095 |
| NPI Number | 1851448146 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/20/2010 |
| Medicare PECOS PAC ID | 8426301177 |
|---|---|
| Medicare Enrollment ID | O20181025001442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851448146 | NPI | - | NPPES |
| 3119549 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 4301043592 (Michigan) | Primary |
| Provider Name | Crystal O'connell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730421371 PECOS PAC ID: 2668778143 Enrollment ID: I20160309001400 |
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