Healthcare Provider Details

I. General information

NPI: 1134834161
Provider Name (Legal Business Name): FLOWERS HAVEN COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 W M 72 HWY
GRAYLING MI
49738-1226
US

IV. Provider business mailing address

300 SPRUCE ST
GRAYLING MI
49738-1622
US

V. Phone/Fax

Practice location:
  • Phone: 989-889-6609
  • Fax:
Mailing address:
  • Phone: 989-915-2009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH NACK
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 989-915-2009