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General NPI Number Information
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NPI Number | 1366014052
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Entity Type | Organization
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Legal Business Name | KALAMAZOO COUNSELING & WELLNESS, LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 1203 MILES AVE
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City | KALAMAZOO
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State | MI
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Zip | 49001-4931
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Country | US
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Telephone | 734-778-0319
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Fax | 269-620-6248
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Provider Business Mailing Address
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Address Line | 1203 MILES AVE
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City | KALAMAZOO
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State | MI
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Zip | 49001-4931
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Country | US
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Telephone | 734-778-0319
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Fax | 269-620-6248
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ERIN JOLIE PRAEDEL
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Credential | LPC, LMFT
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Telephone | 734-778-0319
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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 |
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License Number State |
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