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General NPI Number Information
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NPI Number | 1194115840
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Entity Type | Organization
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Legal Business Name | RESOLUTION COUNSELING
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 5840 LORAC DR STE 5
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City | CLARKSTON
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State | MI
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Zip | 48346-2915
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Country | US
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Telephone | 248-249-0989
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Fax | 248-625-0945
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Provider Business Mailing Address
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Address Line | 5840 LORAC DR STE 5
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City | CLARKSTON
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State | MI
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Zip | 48346-2915
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Country | US
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Telephone | 248-249-0989
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Fax | 248-625-0945
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | CHARLES R YOUNG
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Credential | MA, LPC
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Telephone | 248-249-0989
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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 | 6401012760
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License Number State | MI
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