| R Christopher Deboer Pllc | |
|
2395 Jolly Rd Ste 160 Okemos MI 48864-5977 | |
| (517) 918-4371 | |
| Not Available |
| Full Name | R Christopher Deboer Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2395 Jolly Rd Ste 160, Okemos, Michigan |
| Authorized Official Name and Position | Ryan Christopher Deboer (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5179184371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Christopher Deboer Pllc 433 Dorrance Pl Lansing MI 48912-1501 Ph: (517) 918-4371 | R Christopher Deboer Pllc 2395 Jolly Rd Ste 160 Okemos MI 48864-5977 Ph: (517) 918-4371 |
| NPI Number | 1225594187 |
|---|---|
| Provider Enumeration Date | 02/15/2019 |
| Last Update Date | 06/26/2020 |
| Certification Date | 06/26/2020 |
| Medicare PECOS PAC ID | 7416375001 |
|---|---|
| Medicare Enrollment ID | O20200914002519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225594187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Alison L Cisneros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568801454 PECOS PAC ID: 6103124797 Enrollment ID: I20160414001938 |
| Provider Name | William J Sweeter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730561218 PECOS PAC ID: 3072872456 Enrollment ID: I20180110000245 |
| Provider Name | Kira Diane Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164052932 PECOS PAC ID: 3678983533 Enrollment ID: I20201104000228 |
| Provider Name | William Beamish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912457516 PECOS PAC ID: 2264822055 Enrollment ID: I20211210000203 |
| Provider Name | Brandi Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770238743 PECOS PAC ID: 5193119964 Enrollment ID: I20220222001732 |
| Provider Name | Carmen Elias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164917480 PECOS PAC ID: 7719371467 Enrollment ID: I20220223002478 |
| Provider Name | Ryan Deboer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164954053 PECOS PAC ID: 9234557828 Enrollment ID: I20240110000620 |
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