| Therapy Services Of Clarkston | |
|
6770 Dixie Highway, Suite 103 Clarkston MI 48346 | |
| (248) 992-7726 | |
| Not Available |
| Full Name | Therapy Services Of Clarkston |
|---|---|
| Speciality | Clinic/Center |
| Location | 6770 Dixie Highway, Suite 103, Clarkston, Michigan |
| Authorized Official Name and Position | Dianne G Sache (OFFICE MANAGER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2489227726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Services Of Clarkston 6770 Dixie Highway, Suite 103 Clarkston MI 48346 Ph: (248) 992-7726 | Therapy Services Of Clarkston 6770 Dixie Highway, Suite 103 Clarkston MI 48346 Ph: (248) 992-7726 |
| NPI Number | 1497399745 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Medicare PECOS PAC ID | 6103261532 |
|---|---|
| Medicare Enrollment ID | O20240226001593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497399745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | David Louis Castine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225030190 PECOS PAC ID: 9032160411 Enrollment ID: I20050202000840 |
| Provider Name | Angelo Gilmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881348589 PECOS PAC ID: 9436536638 Enrollment ID: I20220509001675 |
| Provider Name | Joseph S Harman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639399140 PECOS PAC ID: 6608212592 Enrollment ID: I20240314000523 |
| Provider Name | Belinda Taft |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013283928 PECOS PAC ID: 4789020561 Enrollment ID: I20240314004068 |
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