| Kids Creek Family Counseling, Llc | |
|
5024 N Royal Dr Ste B Traverse City MI 49684-9230 | |
| (231) 632-4490 | |
| Not Available |
| Full Name | Kids Creek Family Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5024 N Royal Dr Ste B, Traverse City, Michigan |
| Authorized Official Name and Position | Amber Lee (OWNER) |
| Authorized Official Contact | 2316324490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Creek Family Counseling, Llc Po Box 2257 Chesterton IN 46304-0357 Ph: (219) 926-8320 | Kids Creek Family Counseling, Llc 5024 N Royal Dr Ste B Traverse City MI 49684-9230 Ph: (231) 632-4490 |
| NPI Number | 1598218315 |
|---|---|
| Provider Enumeration Date | 07/28/2016 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 4385925122 |
|---|---|
| Medicare Enrollment ID | O20170110000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598218315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amber Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437378254 PECOS PAC ID: 2860480290 Enrollment ID: I20040504001464 |
| Provider Name | Margaret Million |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467715151 PECOS PAC ID: 7416239868 Enrollment ID: I20170120000649 |
| Provider Name | Leona Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467901694 PECOS PAC ID: 2961744107 Enrollment ID: I20190508002068 |
| Provider Name | Rachel Danielle Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174073076 PECOS PAC ID: 4284966540 Enrollment ID: I20191106000966 |
| Provider Name | Jenifer Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902450596 PECOS PAC ID: 8325412729 Enrollment ID: I20230327001795 |
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