MEDICARE: INTEGRATED ANXIETY MANAGEMENT (IAM)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1992450126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED ANXIETY MANAGEMENT (IAM)

Provider Business Mailing Address
First Line	:	12899 W HERBISON RD
Second Line	:
City	:	EAGLE
State	:	MI
Zip	:	48822-9648
Country	:	US
Telephone Number	:	517-242-1762
Fax Number	:	517-247-2844

Provider Business Practice Location Address
First Line	:	12899 W HERBISON RD
Second Line	:
City	:	EAGLE
State	:	MI
Zip	:	48822-9648
Country	:	US
Telephone Number	:	517-242-1762
Fax Number	:	517-247-2844

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SUSAN MARIE BECKMAN-MITCHELL
Credential	:	MA, LPC
Telephone Number	:	517-242-1762

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	02/13/2024

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Directions to “INTEGRATED ANXIETY MANAGEMENT (IAM) ” Practice Location

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