Healthcare Provider Details

I. General information

NPI: 1588708184
Provider Name (Legal Business Name): ARBORVIEW COUNSELING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 N MAIN ST UNIT 31, SUITE 12H
GRANGER IN
46530-9680
US

IV. Provider business mailing address

30613 REDFIELD ST
NILES MI
49120-5083
US

V. Phone/Fax

Practice location:
  • Phone: 269-782-2489
  • Fax: 269-782-2489
Mailing address:
  • Phone: 866-845-4026
  • Fax: 866-804-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number31894C
License Number StateMI

VIII. Authorized Official

Name: MRS. NICOLE M TAULBEE
Title or Position: CO-PRESIDENT
Credential: MA LMHC
Phone: 866-845-4026