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General NPI Number Information
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NPI Number | 1053617225
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Entity Type | Organization
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Legal Business Name | NORTHSTAR COUNSELING AND HERBALS LLC
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 321 E LAKE ST SUITE #2
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City | PETOSKEY
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State | MI
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Zip | 49770-2478
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Country | US
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Telephone | 231-392-6957
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 501
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City | MANCELONA
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State | MI
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Zip | 49659-0501
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Country | US
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Telephone | 231-587-5632
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Fax |
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Authorized Official
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Title or Position | OWNER AND FOUNDER
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Name | MS. WENDY DREWS
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Credential | LMSW
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Telephone | 231-587-5632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6801080915
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License Number State | MI
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