| Prominent Life Changes Therapy Group. P.c. | |
|
2844 Livernois Road Unit 1434 Troy MI 48099 | |
| (586) 942-1430 | |
| Not Available |
| Full Name | Prominent Life Changes Therapy Group. P.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2844 Livernois Road, Troy, Michigan |
| Authorized Official Name and Position | Wendy Vaughter (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5869421430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prominent Life Changes Therapy Group. P.c. Po Box 1434 Troy MI 48099 Ph: (586) 942-1430 | Prominent Life Changes Therapy Group. P.c. 2844 Livernois Road Unit 1434 Troy MI 48099 Ph: (586) 942-1430 |
| NPI Number | 1326707399 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326707399 | NPI | - | NPPES |
| 1417419318 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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