| Petoskey Psychological Health And Wellness, Pllc | |
|
2810 Charlevoix Rd Ste 102 Petoskey MI 49770-8421 | |
| (231) 340-9113 | |
| (231) 642-9116 |
| Full Name | Petoskey Psychological Health And Wellness, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2810 Charlevoix Rd Ste 102, Petoskey, Michigan |
| Authorized Official Name and Position | Rebecca Roth (OWNER) |
| Authorized Official Contact | 2313409113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petoskey Psychological Health And Wellness, Pllc Po Box 133 Petoskey MI 49770-0133 Ph: (231) 340-9113 | Petoskey Psychological Health And Wellness, Pllc 2810 Charlevoix Rd Ste 102 Petoskey MI 49770-8421 Ph: (231) 340-9113 |
| NPI Number | 1831666288 |
|---|---|
| Provider Enumeration Date | 10/24/2018 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Medicare PECOS PAC ID | 5698012201 |
|---|---|
| Medicare Enrollment ID | O20190121000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831666288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael A Morey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467750778 PECOS PAC ID: 0547498545 Enrollment ID: I20140121001881 |
| Provider Name | Rebecca L Roth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568659126 PECOS PAC ID: 4385981356 Enrollment ID: I20190129002100 |
| Provider Name | Lynn C Neely |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134365307 PECOS PAC ID: 6709021520 Enrollment ID: I20221205003186 |
| Provider Name | Elizabeth B Mccormack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225095193 PECOS PAC ID: 5092186486 Enrollment ID: I20230123001088 |
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