| Hope's Halo Therapy Collective, Pllc | |
|
1010 W Villas Dr Vicksburg MI 49097-9626 | |
| (269) 760-1011 | |
| Not Available |
| Full Name | Hope's Halo Therapy Collective, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1010 W Villas Dr, Vicksburg, Michigan |
| Authorized Official Name and Position | Azmen Hope Williams (OWNER/THERAPIST) |
| Authorized Official Contact | 2697601011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope's Halo Therapy Collective, Pllc 417 Forest St # 532 Kalamazoo MI 49001-2747 Ph: (269) 760-1011 | Hope's Halo Therapy Collective, Pllc 1010 W Villas Dr Vicksburg MI 49097-9626 Ph: (269) 760-1011 |
| NPI Number | 1548988207 |
|---|---|
| Provider Enumeration Date | 08/18/2022 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 9436511425 |
|---|---|
| Medicare Enrollment ID | O20230808000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548988207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Azmen Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144581174 PECOS PAC ID: 1951643535 Enrollment ID: I20190501000627 |
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