Healthcare Provider Details

I. General information

NPI: 1548482029
Provider Name (Legal Business Name): WOMEN'S RESOURCE CENTER OF NORTHERN MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 PORTER ST
PETOSKEY MI
49770-2844
US

IV. Provider business mailing address

423 PORTER ST
PETOSKEY MI
49770-2844
US

V. Phone/Fax

Practice location:
  • Phone: 231-347-0067
  • Fax:
Mailing address:
  • Phone: 231-347-0067
  • 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 Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JANET M MANCINELLI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 231-347-0067