Healthcare Provider Details

I. General information

NPI: 1790285195
Provider Name (Legal Business Name): U.P. COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 RUBLEIN ST STE D
MARQUETTE MI
49855-4060
US

IV. Provider business mailing address

201 RUBLEIN ST STE D
MARQUETTE MI
49855-4060
US

V. Phone/Fax

Practice location:
  • Phone: 906-250-7533
  • Fax:
Mailing address:
  • Phone: 906-250-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. JESSICA HEIDTMAN
Title or Position: OWNER
Credential: LMSW
Phone: 906-250-7533