| Peggy Liss Msw, L.l.c. | |
|
2311 Glenwood Dr Kalamazoo MI 49008-1978 | |
| (269) 598-3886 | |
| Not Available |
| Full Name | Peggy Liss Msw, L.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2311 Glenwood Dr, Kalamazoo, Michigan |
| Authorized Official Name and Position | Peggy Liss (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2695983886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peggy Liss Msw, L.l.c. 2311 Glenwood Dr Kalamazoo MI 49008-1978 Ph: (269) 598-3886 | Peggy Liss Msw, L.l.c. 2311 Glenwood Dr Kalamazoo MI 49008-1978 Ph: (269) 598-3886 |
| NPI Number | 1770143109 |
|---|---|
| Provider Enumeration Date | 06/18/2019 |
| Last Update Date | 06/18/2019 |
| Medicare PECOS PAC ID | 9133551781 |
|---|---|
| Medicare Enrollment ID | O20191120000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770143109 | NPI | - | NPPES |
| 1285690685 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Peggy S Liss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285690685 PECOS PAC ID: 1355521071 Enrollment ID: I20110211000387 |
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