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General NPI Number Information
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NPI Number | 1497240097
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Entity Type | Organization
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Legal Business Name | KINGDOM COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 1806 LINDY DR
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City | LANSING
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State | MI
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Zip | 48917-9734
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Country | US
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Telephone | 517-940-0905
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 LINDY DR
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City | LANSING
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State | MI
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Zip | 48917-9734
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Country | US
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Telephone | 517-940-0905
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA PENA
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Credential | LMSW
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Telephone | 517-940-0905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801089519
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License Number State | MI
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