| Moxie Mental Health | |
|
4000 Portage St Ste 207-208 Kalamazoo MI 49001-6900 | |
| (269) 251-7313 | |
| Not Available |
| Full Name | Moxie Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 4000 Portage St Ste 207-208, Kalamazoo, Michigan |
| Authorized Official Name and Position | Rebecca Beronja (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 2692517313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moxie Mental Health 2432 Kalarama Ave Portage MI 49024-3228 Ph: (269) 251-7313 | Moxie Mental Health 4000 Portage St Ste 207-208 Kalamazoo MI 49001-6900 Ph: (269) 251-7313 |
| NPI Number | 1467132837 |
|---|---|
| Provider Enumeration Date | 07/20/2023 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 2567997307 |
|---|---|
| Medicare Enrollment ID | O20241203001144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467132837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kevin Dale Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063646875 PECOS PAC ID: 7719335140 Enrollment ID: I20231127000747 |
| Provider Name | Rebecca Lynn Beronja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386975951 PECOS PAC ID: 6103351945 Enrollment ID: I20241203001225 |
| Provider Name | Dannielle Kostrab-boyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033977954 PECOS PAC ID: 9931639168 Enrollment ID: I20250204000153 |
| Provider Name | Casey J Coker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023315991 PECOS PAC ID: 7214457001 Enrollment ID: I20250224002376 |
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