| Lifeways | |
|
1200 N. West Avenue Jackson MI 49202 | |
| (517) 789-1200 | |
| (517) 789-1276 |
| Full Name | Lifeways |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 N. West Avenue, Jackson, Michigan |
| Authorized Official Name and Position | Maribeth J Leonard (CHIEF EXECUTIVE OFFICER (CEO)) |
| Authorized Official Contact | 5177891209 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeways 1200 N. West Avenue Jackson MI 49202 Ph: (517) 789-1200 | Lifeways 1200 N. West Avenue Jackson MI 49202 Ph: (517) 789-1200 |
| NPI Number | 1063466274 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 11/24/2021 |
| Certification Date | 11/24/2021 |
| Medicare PECOS PAC ID | 6406808062 |
|---|---|
| Medicare Enrollment ID | O20050211000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063466274 | NPI | - | NPPES |
| 1712229 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Manish Prasad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558395947 PECOS PAC ID: 8325096340 Enrollment ID: I20050106000592 |
| Provider Name | Zakia I Alavi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154474617 PECOS PAC ID: 2567411820 Enrollment ID: I20050114000209 |
| Provider Name | Aleksandra Wilanowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356418347 PECOS PAC ID: 6406957406 Enrollment ID: I20070720000369 |
| Provider Name | Dele Omije |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568607471 PECOS PAC ID: 5597934166 Enrollment ID: I20140417000626 |
| Provider Name | Charleitte Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972843126 PECOS PAC ID: 4284850025 Enrollment ID: I20140730002714 |
| Provider Name | Edward L Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477579266 PECOS PAC ID: 5496048266 Enrollment ID: I20160801002499 |
| Provider Name | Paul S Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790862225 PECOS PAC ID: 9638203789 Enrollment ID: I20171101001953 |
| Provider Name | Thomas R Best |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750540068 PECOS PAC ID: 6800920075 Enrollment ID: I20191213000404 |
| Provider Name | Lily S. Chung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508963273 PECOS PAC ID: 7618943093 Enrollment ID: I20200507000249 |
| Provider Name | Jessica Erin Gibbons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548754898 PECOS PAC ID: 4587082391 Enrollment ID: I20200910002467 |
| Provider Name | Marcyan Elizabeth Irwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356766687 PECOS PAC ID: 8022408624 Enrollment ID: I20211213002484 |
| Provider Name | Matthew Soden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013258631 PECOS PAC ID: 0941595607 Enrollment ID: I20220621001026 |
| Provider Name | Jessica Tucelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235797846 PECOS PAC ID: 3577943091 Enrollment ID: I20220630000626 |
| Provider Name | Adam J Colden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982251724 PECOS PAC ID: 0648645788 Enrollment ID: I20230404000130 |
| Provider Name | Darcy Lyn Herrera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396416947 PECOS PAC ID: 4981062247 Enrollment ID: I20230617000194 |
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Cycle Of Life Support Chs Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 E Ganson St, Jackson, MI 49202 Phone: 616-275-8930 Fax: 616-608-3693 | |
Inner Guidance Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 608 W Michigan Ave, Jackson, MI 49201 Phone: 517-416-8878 Fax: 517-962-5316 | |
Center For Family Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 N Jackson St, Jackson, MI 49201 Phone: 517-748-5500 | |
Lifeways Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N. West Avenue, Jackson, MI 49202 Phone: 517-780-3332 Fax: 517-796-4532 | |
Highfields Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1206 Clinton Rd, Jackson, MI 49202 Phone: 517-783-4250 |