| Sallie Parker Lmsw, Pllc | |
|
2035 Hogback Rd Suite 207 Ann Arbor MI 48105-9666 | |
| (734) 476-1973 | |
| Not Available |
| Full Name | Sallie Parker Lmsw, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2035 Hogback Rd, Ann Arbor, Michigan |
| Authorized Official Name and Position | Sallie Kay Parker (OWNER) |
| Authorized Official Contact | 7344761973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sallie Parker Lmsw, Pllc 3106 Fawnmeadow Ct Ann Arbor MI 48105-9666 Ph: (734) 476-1973 | Sallie Parker Lmsw, Pllc 2035 Hogback Rd Suite 207 Ann Arbor MI 48105-9666 Ph: (734) 476-1973 |
| NPI Number | 1386124576 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 08/16/2018 |
| Medicare PECOS PAC ID | 5294084539 |
|---|---|
| Medicare Enrollment ID | O20180821000897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386124576 | NPI | - | NPPES |
| 1821210238 | Other | MI | NPI 1 |
| 64097177 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6801058484 (Michigan) | Primary |
| Provider Name | Sallie K Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821210238 PECOS PAC ID: 9133365570 Enrollment ID: I20130409000626 |
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