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General NPI Number Information
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NPI Number | 1447880265
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Entity Type | Organization
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Legal Business Name | FIELDSTONE COUNSELING & WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 9191 DIXIE HWY
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City | CLARKSTON
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State | MI
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Zip | 48348-4248
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Country | US
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Telephone | 248-343-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 2494 LANSBURY DR
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City | WATERFORD
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State | MI
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Zip | 48329-2322
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Country | US
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Telephone | 248-343-8455
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MEGAN MCCLAIN
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Credential |
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Telephone | 248-249-1520
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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 |
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License Number State |
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