| River Way Psychological Services | |
|
975 Spaulding Ave Se Ste D Ada MI 49301-3776 | |
| (231) 881-2416 | |
| Not Available |
| Full Name | River Way Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 975 Spaulding Ave Se Ste D, Ada, Michigan |
| Authorized Official Name and Position | Cheryl Elaine Samuels (OWNER) |
| Authorized Official Contact | 2318812416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Way Psychological Services Po Box 213 Grandville MI 49468-0213 Ph: (231) 881-2416 | River Way Psychological Services 975 Spaulding Ave Se Ste D Ada MI 49301-3776 Ph: (231) 881-2416 |
| NPI Number | 1407494982 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Medicare PECOS PAC ID | 6305274853 |
|---|---|
| Medicare Enrollment ID | O20200316000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407494982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cheryl E Samuels |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205042827 PECOS PAC ID: 2062775075 Enrollment ID: I20180404000918 |
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