Healthcare Provider Details

I. General information

NPI: 1174019756
Provider Name (Legal Business Name): C3 - CILUFFO COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 S BRIDGE ST
BELDING MI
48809-1764
US

IV. Provider business mailing address

360 E TUTTLE RD LOT 141
IONIA MI
48846-8624
US

V. Phone/Fax

Practice location:
  • Phone: 616-902-6232
  • Fax:
Mailing address:
  • Phone: 616-902-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA M CILUFFO
Title or Position: OWNER. THERAPIST
Credential: LPC, CAADC
Phone: 616-902-6232