| Michigan Therapeutic Consultants Pc | |
|
4273 Corporate Way Mount Pleasant MI 48858 | |
| (989) 953-4357 | |
| (989) 953-4358 |
| Full Name | Michigan Therapeutic Consultants Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4273 Corporate Way, Mount Pleasant, Michigan |
| Authorized Official Name and Position | Jemece Michelle Gasaway (DIRECTOR OF LICENSING) |
| Authorized Official Contact | 2143656126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Therapeutic Consultants Pc 5001 Spring Valley Rd Ste 600 Dallas TX 75244-3946 Ph: (214) 365-6100 | Michigan Therapeutic Consultants Pc 4273 Corporate Way Mount Pleasant MI 48858 Ph: (989) 953-4357 |
| NPI Number | 1598932253 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 01/14/2021 |
| Certification Date | 01/14/2021 |
| Medicare PECOS PAC ID | 0749534816 |
|---|---|
| Medicare Enrollment ID | O20181109000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598932253 | NPI | - | NPPES |
| Provider Name | Jeanne M Kapenga |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1891742631 PECOS PAC ID: 8325932288 Enrollment ID: I20040211000616 |
| Provider Name | April R St John-keenoy |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1902971641 PECOS PAC ID: 0749386753 Enrollment ID: I20070509000034 |
| Provider Name | Michael Takashi Okumura |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1720006224 PECOS PAC ID: 8325012446 Enrollment ID: I20081027000766 |
| Provider Name | Jennifer T Hoffman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306812854 PECOS PAC ID: 2365469186 Enrollment ID: I20090325000571 |
| Provider Name | Terry F Nowak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144318866 PECOS PAC ID: 2769677509 Enrollment ID: I20101105001276 |
| Provider Name | Cynthia C Statler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649291048 PECOS PAC ID: 7911156252 Enrollment ID: I20121002000698 |
| Provider Name | Judith Anne Suess |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1780866194 PECOS PAC ID: 4082795778 Enrollment ID: I20181204000861 |
| Provider Name | Lilian Kigonya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932375110 PECOS PAC ID: 4284788654 Enrollment ID: I20230711003574 |
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