Healthcare Provider Details

I. General information

NPI: 1134576911
Provider Name (Legal Business Name): BOVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 MICHIGAN AVE SUITE 109
EAST LANSING MI
48823-4069
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-204-6743
  • Fax:
Mailing address:
  • Phone: 517-676-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801086480
License Number StateMI

VIII. Authorized Official

Name: SARAH E BOVE
Title or Position: OWNER
Credential: LMSW
Phone: 517-204-6743