| Lisa B Whitehead Pllc | |
|
4084 Okemos Rd Ste A Okemos MI 48864-3258 | |
| (517) 347-4848 | |
| Not Available |
| Full Name | Lisa B Whitehead Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4084 Okemos Rd Ste A, Okemos, Michigan |
| Authorized Official Name and Position | Lisa Whitehead (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5173474848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa B Whitehead Pllc 4084 Okemos Rd Ste A Okemos MI 48864-3258 Ph: () - | Lisa B Whitehead Pllc 4084 Okemos Rd Ste A Okemos MI 48864-3258 Ph: (517) 347-4848 |
| NPI Number | 1215399290 |
|---|---|
| Provider Enumeration Date | 03/28/2016 |
| Last Update Date | 07/15/2021 |
| Certification Date | 07/15/2021 |
| Medicare PECOS PAC ID | 9931408119 |
|---|---|
| Medicare Enrollment ID | O20160422001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215399290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801064670 (Michigan) | Primary |
| Provider Name | Lisa B Whitehead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104926880 PECOS PAC ID: 4284714478 Enrollment ID: I20071228000463 |
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