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General NPI Number Information
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NPI Number | 1073107488
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Entity Type | Organization
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Legal Business Name | GLADE COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 540 NAPA VALLEY DR
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City | MILFORD
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State | MI
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Zip | 48381-1055
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Country | US
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Telephone | 810-626-5196
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Fax | 810-626-5197
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Provider Business Mailing Address
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Address Line | 211 N 1ST ST STE 213
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City | BRIGHTON
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State | MI
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Zip | 48116-1297
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Country | US
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Telephone | 810-626-5196
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | NICOLE H GLADE
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Credential | LPC
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Telephone | 810-626-5196
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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 |
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License Number State |
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