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General NPI Number Information
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NPI Number | 1154518652
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Entity Type | Organization
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Legal Business Name | CONNECTION FOR MENTAL HEALTH,PLC
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 200 E MAIN ST STE 200
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City | MIDLAND
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State | MI
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Zip | 48640-6510
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Country | US
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Telephone | 989-633-9021
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Fax | 989-633-9026
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Provider Business Mailing Address
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Address Line | 200 E MAIN ST STE 200
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City | MIDLAND
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State | MI
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Zip | 48640-6510
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Country | US
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Telephone | 989-633-9021
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Fax | 989-633-9026
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. LAURIE DANENE CHAMBERLAIN-CLEMENTS
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Credential | ACSW, LMSW
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Telephone | 989-633-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801017305
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License Number State | MI
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