Healthcare Provider Details

I. General information

NPI: 1679024186
Provider Name (Legal Business Name): HOLY CROSS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 07/21/2022
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8759 CLINTON MACON RD
CLINTON MI
49236-9572
US

IV. Provider business mailing address

444 CORNELL DRIVE
BATTLE CREEK MI
49017
US

V. Phone/Fax

Practice location:
  • Phone: 517-423-7455
  • Fax:
Mailing address:
  • Phone: 517-423-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6802087250
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6802087250
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6802087250
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6802087250
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number6802087250
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number6802087250
License Number StateMI
# 7
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number6802087250
License Number StateMI

VIII. Authorized Official

Name: PAULINE M BAUDOUX
Title or Position: REGIONAL OFFICE COORDINATOR
Credential:
Phone: 989-596-3558