| Timothy Egan Lmsw, Llc | |
|
26098 E Huron River Dr Flat Rock MI 48134-1256 | |
| (248) 459-0022 | |
| Not Available |
| Full Name | Timothy Egan Lmsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 26098 E Huron River Dr, Flat Rock, Michigan |
| Authorized Official Name and Position | Timothy Patrick Egan (OWNER) |
| Authorized Official Contact | 2484590022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Egan Lmsw, Llc 26098 E Huron River Dr Flat Rock MI 48134-1256 Ph: (248) 459-0022 | Timothy Egan Lmsw, Llc 26098 E Huron River Dr Flat Rock MI 48134-1256 Ph: (248) 459-0022 |
| NPI Number | 1902554975 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 03/17/2022 |
| Certification Date | 03/17/2022 |
| Medicare PECOS PAC ID | 6800262239 |
|---|---|
| Medicare Enrollment ID | O20221026000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902554975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Timothy Egan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356811129 PECOS PAC ID: 2860869203 Enrollment ID: I20221027002913 |
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