| Tmcm4 Llc | |
|
271 Woodland Pass Ste 216 East Lansing MI 48823-2060 | |
| (517) 347-6944 | |
| (517) 347-6912 |
| Full Name | Tmcm4 Llc |
|---|---|
| Speciality | Social Worker |
| Location | 271 Woodland Pass Ste 216, East Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tmcm4 Llc Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Tmcm4 Llc 271 Woodland Pass Ste 216 East Lansing MI 48823-2060 Ph: (517) 347-6944 |
| NPI Number | 1184171498 |
|---|---|
| Provider Enumeration Date | 09/02/2016 |
| Last Update Date | 05/14/2021 |
| Certification Date | 05/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184171498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | 6801059540 (Michigan) | Secondary |
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