| Katie M Wyss Lmsw, Llc | |
|
218 N 4th Ave Ste 207 Ann Arbor MI 48104-1472 | |
| (734) 926-9189 | |
| Not Available |
| Full Name | Katie M Wyss Lmsw, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 218 N 4th Ave Ste 207, Ann Arbor, Michigan |
| Authorized Official Name and Position | Katie Millis Wyss (OWNER) |
| Authorized Official Contact | 7349269189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie M Wyss Lmsw, Llc 428 Shiloh Drive Chelsea MI 48118 Ph: (734) 926-9189 | Katie M Wyss Lmsw, Llc 218 N 4th Ave Ste 207 Ann Arbor MI 48104-1472 Ph: (734) 926-9189 |
| NPI Number | 1558978593 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 03/05/2021 |
| Certification Date | 03/05/2021 |
| Medicare PECOS PAC ID | 8729491782 |
|---|---|
| Medicare Enrollment ID | O20210112000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558978593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Katie Millis Wyss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437593324 PECOS PAC ID: 1658639299 Enrollment ID: I20180103000758 |
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