Healthcare Provider Details

I. General information

NPI: 1972053809
Provider Name (Legal Business Name): POSITIVE SOLUTIONS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E MAUMEE ST STE 7
ADRIAN MI
49221-2735
US

IV. Provider business mailing address

142 E MAUMEE ST STE 7
ADRIAN MI
49221-2735
US

V. Phone/Fax

Practice location:
  • Phone: 517-539-2518
  • Fax:
Mailing address:
  • Phone: 517-539-2518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011293
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6401011293
License Number StateMI

VIII. Authorized Official

Name: DALE WILLIAM EICHENBERG
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 517-539-2518