| In Our Practice Psychotherapy Private Practice | |
| 
					3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157  | |
| (989) 272-3727 | |
| (989) 355-0447 | 
| Full Name | In Our Practice Psychotherapy Private Practice | 
|---|---|
| Speciality | Social Worker | 
| Location | 3400 Shattuck Rd Ste 2, Saginaw, Michigan | 
| Authorized Official Name and Position | Stacy Lynn Athens (SOLE MEMBER) | 
| Authorized Official Contact | 9892723727 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| In Our Practice Psychotherapy Private Practice 3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157 Ph: (989) 272-3727  | In Our Practice Psychotherapy Private Practice 3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157 Ph: (989) 272-3727  | 
| NPI Number | 1124666714 | 
|---|---|
| Provider Enumeration Date | 12/15/2019 | 
| Last Update Date | 02/16/2022 | 
| Certification Date | 02/16/2022 | 
| Medicare PECOS PAC ID | 5193135218 | 
|---|---|
| Medicare Enrollment ID | O20201030002437 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1124666714 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary | 
| Provider Name | Stacy Athens | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1205369626 PECOS PAC ID: 2466738679 Enrollment ID: I20170424000732  | 
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