| Inner Light Therapy Llc | |
|
4345 Tracy Trail Ct Dorr MI 49323-9007 | |
| (269) 908-0245 | |
| Not Available |
| Full Name | Inner Light Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4345 Tracy Trail Ct, Dorr, Michigan |
| Authorized Official Name and Position | Mckinzie Deweerd (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 2699080245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Light Therapy Llc 4345 Tracy Trail Ct Dorr MI 49323-9007 Ph: (269) 908-0245 | Inner Light Therapy Llc 4345 Tracy Trail Ct Dorr MI 49323-9007 Ph: (269) 908-0245 |
| NPI Number | 1336910694 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 02/10/2025 |
| Certification Date | 02/10/2025 |
| Medicare PECOS PAC ID | 4880117209 |
|---|---|
| Medicare Enrollment ID | O20250326003023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336910694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mckinzie Deweerd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750998738 PECOS PAC ID: 0446625883 Enrollment ID: I20230417001507 |
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Amdg Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1853 136th Ave, Dorr, MI 49323 Phone: 269-793-7672 |