Ame Mae Edstrom, LLMFT
Individual provider Active NPI Marriage & Family Therapist · Hersey, MI
NPI 1346789179 · NPPES record last updated Feb 13, 2017
Key facts
- NPI
- 1346789179
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 4101006505 (MI)
- Practice address
- 4507 170TH Ave
Hersey, MI 49639-8785 - Phone
- (231) 832-2234
- Fax
- (231) 832-0385
- NPI assigned
- Feb 13, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101006505 | MI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Village Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101006505 | MI | Yes |
Addresses
Primary practice location
4507 170TH Ave
Hersey, MI 49639-8785
Mailing address
4507 170TH Ave
Hersey, MI 49639-8785
Phone (231) 832-2234
Other providers in Hersey, MI
- Jennifer Carrie Benedict
- Diane Marie Bluhm
- DLT Home Help Services
- Eagle Village Inc
- Allyson Frederick
- Brett Grabiel
- Danielle C Holland
- Kaycie Sue Jacobs
- Alicia Elizabeth Kelenske
All providers in Hersey, MI · Marriage & Family Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.