| Out Side In, Inc. | |
|
12511 152nd Avenue Grand Haven MI 49417 | |
| (616) 844-0906 | |
| Not Available |
| Full Name | Out Side In, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 12511 152nd Avenue, Grand Haven, Michigan |
| Authorized Official Name and Position | Lexie Carr (PROGRAM MANAGER) |
| Authorized Official Contact | 6168440906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Out Side In, Inc. 12511 152nd Avenue Grand Haven MI 49417 Ph: (616) 405-7986 | Out Side In, Inc. 12511 152nd Avenue Grand Haven MI 49417 Ph: (616) 844-0906 |
| NPI Number | 1922306323 |
|---|---|
| Provider Enumeration Date | 03/09/2011 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 3870895527 |
|---|---|
| Medicare Enrollment ID | O20160112002059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922306323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801077678 (Michigan) | Primary |
| Provider Name | Jennifer D Mcvoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871891275 PECOS PAC ID: 0941502603 Enrollment ID: I20160119002053 |
| Provider Name | Lizabeth A Sperry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801305214 PECOS PAC ID: 0749518553 Enrollment ID: I20190817000340 |
| Provider Name | Susan L Dice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336727551 PECOS PAC ID: 2961890066 Enrollment ID: I20211021003014 |
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