| Self-reflections Therapeutic Services Inc. | |
|
524 Ludington St, Suite 105 Escanaba MI 49829 | |
| (906) 420-1132 | |
| Not Available |
| Full Name | Self-reflections Therapeutic Services Inc. |
|---|---|
| Speciality | Counselor |
| Location | 524 Ludington St, Suite 105, Escanaba, Michigan |
| Authorized Official Name and Position | Nisha Lee Tebear-coolman (CEO) |
| Authorized Official Contact | 9064201132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Self-reflections Therapeutic Services Inc. 524 Ludington St, Suite 105 Escanaba MI 49829 Ph: (906) 420-1132 | Self-reflections Therapeutic Services Inc. 524 Ludington St, Suite 105 Escanaba MI 49829 Ph: (906) 420-1132 |
| NPI Number | 1033826904 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 11/01/2022 |
| Certification Date | 11/01/2022 |
| Medicare PECOS PAC ID | 9830568674 |
|---|---|
| Medicare Enrollment ID | O20221216001953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033826904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael P St. John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992052609 PECOS PAC ID: 7315165339 Enrollment ID: I20140904000183 |
| Provider Name | Nisha Tebear-coolman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710366497 PECOS PAC ID: 6800296559 Enrollment ID: I20210616003622 |
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