| Your Path Therapy Group, Pllc | |
|
44444 Hayes Rd Clinton Township MI 48038-7600 | |
| (586) 210-6682 | |
| Not Available |
| Full Name | Your Path Therapy Group, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 44444 Hayes Rd, Clinton Township, Michigan |
| Authorized Official Name and Position | Gage L Peavler (PRESIDENT) |
| Authorized Official Contact | 5867701202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Path Therapy Group, Pllc 17693 Maisons Dr Clinton Township MI 48038-3802 Ph: (586) 322-5905 | Your Path Therapy Group, Pllc 44444 Hayes Rd Clinton Township MI 48038-7600 Ph: (586) 210-6682 |
| NPI Number | 1215795224 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 5092250076 |
|---|---|
| Medicare Enrollment ID | O20240715001397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215795224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gage Peavler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922691120 PECOS PAC ID: 5395100838 Enrollment ID: I20230505000309 |
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