| Hartland Individual And Family Services Llc | |
|
11750 Highland Rd Ste 140 Hartland MI 48353-2729 | |
| (810) 746-9091 | |
| Not Available |
| Full Name | Hartland Individual And Family Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11750 Highland Rd Ste 140, Hartland, Michigan |
| Authorized Official Name and Position | Marybeth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hartland Individual And Family Services Llc 11750 Highland Rd Ste 140 Hartland MI 48353-2729 Ph: () - | Hartland Individual And Family Services Llc 11750 Highland Rd Ste 140 Hartland MI 48353-2729 Ph: (810) 746-9091 |
| NPI Number | 1184203564 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 05/25/2021 |
| Certification Date | 05/25/2021 |
| Medicare PECOS PAC ID | 8921416033 |
|---|---|
| Medicare Enrollment ID | O20210408002779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184203564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Leslie Lynne Dicosola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174828172 PECOS PAC ID: 0941484034 Enrollment ID: I20110414000372 |
| Provider Name | Erin Michelle Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053726307 PECOS PAC ID: 0840410684 Enrollment ID: I20140930001241 |
| Provider Name | Adrial Mithril Lanterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548544612 PECOS PAC ID: 9739433384 Enrollment ID: I20181116001569 |
| Provider Name | Mikayla Nicole Hershberger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073124566 PECOS PAC ID: 1254860257 Enrollment ID: I20250121001006 |
| Provider Name | Cathleen Marie Hofsess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124556303 PECOS PAC ID: 5395265003 Enrollment ID: I20250225003081 |
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