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General NPI Number Information
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NPI Number | 1154562775
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Entity Type | Organization
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Legal Business Name | A CENTER FOR COUNSELING, LLC
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 2427 SPRING ARBOR RD STE 1AND2
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City | JACKSON
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State | MI
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Zip | 49203-2988
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Country | US
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Telephone | 517-474-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 2427 SPRING ARBOR RD STE 1AND2
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City | JACKSON
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State | MI
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Zip | 49203-2988
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Country | US
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Telephone | 517-474-4673
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER, THERAPIST
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Name | MRS. CATHERINE LOUISE HARDWICK
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Credential | ACSW, LMSW
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Telephone | 517-474-4673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801071699
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License Number State | MI
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