| Life Span Counseling Services Pllc | |
|
40206 Ashland Dr Sterling Heights MI 48313-5400 | |
| (586) 551-3102 | |
| Not Available |
| Full Name | Life Span Counseling Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 40206 Ashland Dr, Sterling Heights, Michigan |
| Authorized Official Name and Position | Angie Moquette Miller (SINGLE MEMBER OWNER/CEO) |
| Authorized Official Contact | 5865513102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Span Counseling Services Pllc 40206 Ashland Dr Sterling Heights MI 48313-5400 Ph: (586) 551-3102 | Life Span Counseling Services Pllc 40206 Ashland Dr Sterling Heights MI 48313-5400 Ph: (586) 551-3102 |
| NPI Number | 1801588256 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Medicare PECOS PAC ID | 1951340603 |
|---|---|
| Medicare Enrollment ID | O20050502000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801588256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Angie M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316630171 PECOS PAC ID: 0840187894 Enrollment ID: I20040303000738 |
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