| Leadlight Llc | |
|
8326 S Division Ave Byron Center MI 49315-9031 | |
| (847) 651-2084 | |
| Not Available |
| Full Name | Leadlight Llc |
|---|---|
| Speciality | Counselor |
| Location | 8326 S Division Ave, Byron Center, Michigan |
| Authorized Official Name and Position | Lindsey Nb Blodgett (OWNER) |
| Authorized Official Contact | 8476512084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leadlight Llc 217 E 24th St Ste 201 Holland MI 49423-4973 Ph: () - | Leadlight Llc 8326 S Division Ave Byron Center MI 49315-9031 Ph: (847) 651-2084 |
| NPI Number | 1578279998 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 4284161233 |
|---|---|
| Medicare Enrollment ID | O20250102002549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578279998 | NPI | - | NPPES |
| Provider Name | Kyle Boer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891187175 PECOS PAC ID: 8921476409 Enrollment ID: I20221115002604 |
| Provider Name | Lindsey Nicole Bandy Blodgett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457730954 PECOS PAC ID: 6002343050 Enrollment ID: I20250102002804 |
| Provider Name | Robert Lewis Eggleston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851912844 PECOS PAC ID: 4789112236 Enrollment ID: I20250110002508 |
| Provider Name | Rachel Maryanna Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326751215 PECOS PAC ID: 4789112251 Enrollment ID: I20250111000071 |
| Provider Name | Matthew Zoerhof |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952936965 PECOS PAC ID: 4082144290 Enrollment ID: I20250203003079 |
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