| Northern Sky Therapeutic Services, Pllc | |
|
150 S Ripley Blvd Alpena MI 49707-3406 | |
| (989) 884-0066 | |
| Not Available |
| Full Name | Northern Sky Therapeutic Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 150 S Ripley Blvd, Alpena, Michigan |
| Authorized Official Name and Position | Renee Diener (PRESIDENT) |
| Authorized Official Contact | 9898840066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Sky Therapeutic Services, Pllc Po Box 586 Alpena MI 49707-0586 Ph: () - | Northern Sky Therapeutic Services, Pllc 150 S Ripley Blvd Alpena MI 49707-3406 Ph: (989) 884-0066 |
| NPI Number | 1043964349 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Medicare PECOS PAC ID | 8426444803 |
|---|---|
| Medicare Enrollment ID | O20220412001663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043964349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Renee L Diener |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205082351 PECOS PAC ID: 7911074711 Enrollment ID: I20080919000529 |
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