Healthcare Provider Details

I. General information

NPI: 1134175607
Provider Name (Legal Business Name): AUBURN COUNSELING ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 S DORT HWY SUITE 44
FLINT MI
48507-2093
US

IV. Provider business mailing address

3600 S DORT HWY SUITE 44
FLINT MI
48507-2093
US

V. Phone/Fax

Practice location:
  • Phone: 810-744-3300
  • Fax: 810-744-1090
Mailing address:
  • Phone: 810-744-3300
  • Fax: 810-744-1090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number250051
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateMI

VIII. Authorized Official

Name: SUSAN M. WEDDA
Title or Position: CEO
Credential: MSW
Phone: 810-744-3300