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General NPI Number Information
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NPI Number | 1164763991
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Entity Type | Organization
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Legal Business Name | HEALTHY HOME CHRISTIAN COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 600 E BROADWAY ST SUITE 200
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City | MT PLEASANT
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State | MI
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Zip | 48858-2701
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Country | US
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Telephone | 989-397-3554
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Fax |
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Provider Business Mailing Address
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Address Line | 228 GRANT AVE
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City | ALMA
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State | MI
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Zip | 48801-2221
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Country | US
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Telephone | 989-397-3554
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. LEON AUSTIN
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Credential | PSY.D., M.S., M.A.
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Telephone | 989-397-3554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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