| Shelly Wiewiora Llc | |
|
433 Seminole Rd Ste 101 Norton Shores MI 49444-3743 | |
| (231) 286-6077 | |
| Not Available |
| Full Name | Shelly Wiewiora Llc |
|---|---|
| Speciality | Counselor |
| Location | 433 Seminole Rd Ste 101, Norton Shores, Michigan |
| Authorized Official Name and Position | Shelly Wiewiora (MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 2312866077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelly Wiewiora Llc 433 Seminole Rd Ste 101 Norton Shores MI 49444-3743 Ph: (231) 286-6077 | Shelly Wiewiora Llc 433 Seminole Rd Ste 101 Norton Shores MI 49444-3743 Ph: (231) 286-6077 |
| NPI Number | 1740068048 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 01/04/2024 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 4284079179 |
|---|---|
| Medicare Enrollment ID | O20240301001233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740068048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shelly Ann Wiewiora |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225280779 PECOS PAC ID: 5193160083 Enrollment ID: I20240306001837 |
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