| Michigan Behavioral Consultants Pc | |
|
2060 E Paris Ave Se Suite 200 Grand Rapids MI 49546-6113 | |
| (616) 285-1377 | |
| (616) 285-1006 |
| Full Name | Michigan Behavioral Consultants Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2060 E Paris Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Eric Willmarth (PRESIDENT) |
| Authorized Official Contact | 6162851377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Behavioral Consultants Pc 5555 Glenwood Hills Pkwy Se Ste 2 Grand Rapids MI 49512-2091 Ph: (616) 940-2662 | Michigan Behavioral Consultants Pc 2060 E Paris Ave Se Suite 200 Grand Rapids MI 49546-6113 Ph: (616) 285-1377 |
| NPI Number | 1336153220 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/30/2021 |
| Medicare PECOS PAC ID | 8426097049 |
|---|---|
| Medicare Enrollment ID | O20050503000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336153220 | NPI | - | NPPES |
| 680D111357 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Sandra Lee Strandquist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912926916 PECOS PAC ID: 8527075266 Enrollment ID: I20060321000418 |
| Provider Name | Craig Vander Maas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497774509 PECOS PAC ID: 8527100460 Enrollment ID: I20100115000212 |
| Provider Name | Eric Willmarth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275638041 PECOS PAC ID: 6204875834 Enrollment ID: I20100312000376 |
| Provider Name | Kandis Deshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740550151 PECOS PAC ID: 9739318536 Enrollment ID: I20140127000566 |
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