Jennifer Bailey Bethechange Counseling Llc | |
1423 Pine Grove Ave Port Huron MI 48060-3513 | |
(810) 434-0640 | |
Not Available |
Full Name | Jennifer Bailey Bethechange Counseling Llc |
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Speciality | Social Worker |
Location | 1423 Pine Grove Ave, Port Huron, Michigan |
Authorized Official Name and Position | Jennifer L Bailey (OWNER) |
Authorized Official Contact | 8104340640 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jennifer Bailey Bethechange Counseling Llc 1423 Pine Grove Ave Port Huron MI 48060-3513 Ph: (810) 434-0640 | Jennifer Bailey Bethechange Counseling Llc 1423 Pine Grove Ave Port Huron MI 48060-3513 Ph: (810) 434-0640 |
NPI Number | 1730820002 |
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Provider Enumeration Date | 04/02/2022 |
Last Update Date | 04/02/2022 |
Certification Date | 04/02/2022 |
Medicare PECOS PAC ID | 5991171118 |
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Medicare Enrollment ID | O20221013000335 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730820002 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Jennifer L Bailey |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164656245 PECOS PAC ID: 5890754139 Enrollment ID: I20041004000611 |
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