| Lighthouse Professional Clinic, P.c. | |
|
409 W Ludington Ave Ste 307 Ludington MI 49431-2377 | |
| (231) 843-8877 | |
| (231) 845-0264 |
| Full Name | Lighthouse Professional Clinic, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 409 W Ludington Ave Ste 307, Ludington, Michigan |
| Authorized Official Name and Position | Stanley L Seuferer (OWNER) |
| Authorized Official Contact | 2318438877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Professional Clinic, P.c. 409 W Ludington Ave Ste 307 Ludington MI 49431-2377 Ph: (231) 843-8877 | Lighthouse Professional Clinic, P.c. 409 W Ludington Ave Ste 307 Ludington MI 49431-2377 Ph: (231) 843-8877 |
| NPI Number | 1407902109 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407902109 | NPI | - | NPPES |
| 100E310320 | Other | MI | BLUE CROSS BLUE SHIELD |
| 100E361760 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 800E310020 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Michigan) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Michigan) | Primary |
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› Verified 9 days ago
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