Healthcare Provider Details

I. General information

NPI: 1447965868
Provider Name (Legal Business Name): BOND COUNSELING & CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 S GARFIELD AVE STE A
TRAVERSE CITY MI
49686-3456
US

IV. Provider business mailing address

PO BOX 230
BUCKLEY MI
49620-0230
US

V. Phone/Fax

Practice location:
  • Phone: 231-253-4891
  • Fax:
Mailing address:
  • Phone: 231-253-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JOAN MARIE LEDFORD
Title or Position: AUTHORIZED OFFICIAL
Credential: LPC, NCC
Phone: 231-253-4891