Healthcare Provider Details

I. General information

NPI: 1801128558
Provider Name (Legal Business Name): FACHTING COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 4TH ST
CLARE MI
48617-1547
US

IV. Provider business mailing address

301 E 4TH ST
CLARE MI
48617-1547
US

V. Phone/Fax

Practice location:
  • Phone: 989-386-8166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL DEAN FACHTING
Title or Position: PSYCHOLOGIST
Credential:
Phone: 989-386-8166