Healthcare Provider Details

I. General information

NPI: 1093908584
Provider Name (Legal Business Name): MITCH A RICE M.A., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ORLEANS BLVD
COLDWATER MI
49036-1767
US

IV. Provider business mailing address

200 ORLEANS BLVD
COLDWATER MI
49036-1767
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-2129
  • Fax: 517-279-8172
Mailing address:
  • Phone: 517-278-2129
  • Fax: 517-279-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401004564
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: