Healthcare Provider Details

I. General information

NPI: 1568958718
Provider Name (Legal Business Name): HOXWORTH COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4695 N M 37 HWY STE A
MIDDLEVILLE MI
49333-8276
US

IV. Provider business mailing address

1509 S BROADWAY ST
HASTINGS MI
49058-2559
US

V. Phone/Fax

Practice location:
  • Phone: 269-205-2402
  • Fax:
Mailing address:
  • Phone: 515-852-4362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301012161
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRET A HOXWORTH
Title or Position: PRESIDENT
Credential: LLP
Phone: 269-205-2402