| Innovative Behavioral Solutions | |
|
3721 W Michigan Ave Ste 200 Lansing MI 48917-3600 | |
| (517) 515-6176 | |
| Not Available |
| Full Name | Innovative Behavioral Solutions |
|---|---|
| Speciality | Social Worker |
| Location | 3721 W Michigan Ave Ste 200, Lansing, Michigan |
| Authorized Official Name and Position | Candace Lynn Tillery (AUTHORIZED OFFICIAL/OFFICE MANAGER) |
| Authorized Official Contact | 5172138185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Behavioral Solutions 3721 W Michigan Ave Ste 200 Lansing MI 48917-3600 Ph: (517) 515-6176 | Innovative Behavioral Solutions 3721 W Michigan Ave Ste 200 Lansing MI 48917-3600 Ph: (517) 515-6176 |
| NPI Number | 1396128088 |
|---|---|
| Provider Enumeration Date | 06/30/2015 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 2365709987 |
|---|---|
| Medicare Enrollment ID | O20171206000988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396128088 | NPI | - | NPPES |
| Provider Name | Ricardo D Tillery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528380623 PECOS PAC ID: 7214294974 Enrollment ID: I20171205002052 |
| Provider Name | Candace Lynn Tillery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114389301 PECOS PAC ID: 4587911755 Enrollment ID: I20180718003493 |
| Provider Name | Michelle L Beard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699110288 PECOS PAC ID: 2860868510 Enrollment ID: I20221020001228 |
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