Healthcare Provider Details

I. General information

NPI: 1174856439
Provider Name (Legal Business Name): COUNSELING ON THE GO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 WEST STREET
READING MI
49274
US

IV. Provider business mailing address

P.O. BOX 645
READING MI
49274
US

V. Phone/Fax

Practice location:
  • Phone: 517-398-0220
  • Fax: 517-901-0066
Mailing address:
  • Phone: 517-398-0220
  • Fax: 517-901-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberL1333720
License Number StateMI

VIII. Authorized Official

Name: MRS. JULIANNE IRENE NORTH
Title or Position: CEO
Credential: LPC
Phone: 517-398-0220