| Phase Mental Health And Wellness Llc | |
|
888 W Big Beaver Rd Ste 780 Troy MI 48084-4745 | |
| (248) 406-6756 | |
| Not Available |
| Full Name | Phase Mental Health And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 888 W Big Beaver Rd Ste 780, Troy, Michigan |
| Authorized Official Name and Position | Courtney Godbout (FOUNDER) |
| Authorized Official Contact | 2482450665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phase Mental Health And Wellness Llc 888 W Big Beaver Rd Ste 780 Troy MI 48084-4745 Ph: (248) 406-6756 | Phase Mental Health And Wellness Llc 888 W Big Beaver Rd Ste 780 Troy MI 48084-4745 Ph: (248) 406-6756 |
| NPI Number | 1821703844 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 07/31/2023 |
| Certification Date | 07/31/2023 |
| Medicare PECOS PAC ID | 3274905625 |
|---|---|
| Medicare Enrollment ID | O20230210001239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821703844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Courtney Billington Godbout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053659268 PECOS PAC ID: 4183096530 Enrollment ID: I20230210001274 |
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