| Pebble Creek Counseling Llc | |
|
710 N Mead St Saint Johns MI 48879-1332 | |
| (989) 224-4110 | |
| Not Available |
| Full Name | Pebble Creek Counseling Llc |
|---|---|
| Speciality | Psychologist |
| Location | 710 N Mead St, Saint Johns, Michigan |
| Authorized Official Name and Position | Elizabeth Ann Olson (STAFF PSYCHOLOGIST) |
| Authorized Official Contact | 9892244110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pebble Creek Counseling Llc 710 N Mead St Saint Johns MI 48879-1332 Ph: (989) 224-4110 | Pebble Creek Counseling Llc 710 N Mead St Saint Johns MI 48879-1332 Ph: (989) 224-4110 |
| NPI Number | 1609095702 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 12/17/2008 |
| Medicare PECOS PAC ID | 8325100829 |
|---|---|
| Medicare Enrollment ID | O20081217000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609095702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301007036 (Michigan) | Primary |
| Provider Name | Elizabeth A Olson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245321884 PECOS PAC ID: 8426110925 Enrollment ID: I20081217000382 |
| Provider Name | Matthew Wayne Olson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023109600 PECOS PAC ID: 6406269976 Enrollment ID: I20240222002527 |
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