MEDICARE: UNBOUND COUNSELING LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1215678420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNBOUND COUNSELING LLC

Provider Business Mailing Address
First Line	:	5820 N CANTON CENTER RD STE 180
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2680
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5820 N CANTON CENTER RD STE 180
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2680
Country	:	US
Telephone Number	:	734-531-7794
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA PECK
Credential	:	LMSW
Telephone Number	:	269-598-6350

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	02/07/2026

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