Healthcare Provider Details

I. General information

NPI: 1366651721
Provider Name (Legal Business Name): MT. PLEASANT COMMUNITY COUNSELING ASSOC. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/17/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SOUTH MAIN STREET SUITE B
MT. PLEASANT MI
48858-3100
US

IV. Provider business mailing address

500 SOUTH MAIN STREET SUITE B
MT. PLEASANT MI
48858-3100
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-0222
  • Fax: 989-772-4241
Mailing address:
  • Phone: 989-773-0222
  • Fax: 989-772-4241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH C KOWALCZYK
Title or Position: OWNER/PRESIDENT
Credential: MA, LPC
Phone: 989-773-0222