| Michael W Elgersma | |
|
262 Chatsworth Ave Sugar Grove IL 60554-9475 | |
| (616) 644-1314 | |
| Not Available |
| Full Name | Michael W Elgersma |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 262 Chatsworth Ave, Sugar Grove, Illinois |
| Authorized Official Name and Position | Nichael W Elgersma (LCPC) |
| Authorized Official Contact | 6166441314 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael W Elgersma 262 Chatsworth Ave Sugar Grove IL 60554-9475 Ph: (616) 644-1314 | Michael W Elgersma 262 Chatsworth Ave Sugar Grove IL 60554-9475 Ph: (616) 644-1314 |
| NPI Number | 1710658844 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 10/24/2021 |
| Certification Date | 10/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710658844 | NPI | - | NPPES |
| 1972946028 | Other | NPI | |
| 366023638001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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