| Kingdom Counseling Services Llc | |
|
1806 Lindy Dr Lansing MI 48917-9734 | |
| (517) 940-0905 | |
| Not Available |
| Full Name | Kingdom Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1806 Lindy Dr, Lansing, Michigan |
| Authorized Official Name and Position | Angela Pena (OWNER) |
| Authorized Official Contact | 5179400905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Counseling Services Llc 1806 Lindy Dr Lansing MI 48917-9734 Ph: (517) 940-0905 | Kingdom Counseling Services Llc 1806 Lindy Dr Lansing MI 48917-9734 Ph: (517) 940-0905 |
| NPI Number | 1497240097 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/04/2023 |
| Medicare PECOS PAC ID | 4486901592 |
|---|---|
| Medicare Enrollment ID | O20180720000796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497240097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 6801089519 (Michigan) | Primary |
| Provider Name | Angela Pena |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053507616 PECOS PAC ID: 4486805926 Enrollment ID: I20121110000135 |
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