| Mary Kelly Lmsw Llc | |
|
1513 Columbus Ave Bay City MI 48708-6824 | |
| (989) 930-7527 | |
| Not Available |
| Full Name | Mary Kelly Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1513 Columbus Ave, Bay City, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Kelly Lmsw Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Mary Kelly Lmsw Llc 1513 Columbus Ave Bay City MI 48708-6824 Ph: (989) 930-7527 |
| NPI Number | 1396581237 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 1456890300 |
|---|---|
| Medicare Enrollment ID | O20240823001520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396581237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Mary Mae Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174953095 PECOS PAC ID: 1456678887 Enrollment ID: I20150324002525 |
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