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General NPI Number Information
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NPI Number | 1558791582
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Entity Type | Organization
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Legal Business Name | ABOUT FACE CHRISTIAN COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 239 N JEBAVY DR
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City | LUDINGTON
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State | MI
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Zip | 49431-2910
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Country | US
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Telephone | 231-425-4036
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Fax |
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Provider Business Mailing Address
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Address Line | 239 N JEBAVY DR
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City | LUDINGTON
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State | MI
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Zip | 49431-2910
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Country | US
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Telephone | 231-425-4036
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | DR. LINDA KOCH
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Credential | LMSW, PHD., SSW,
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Telephone | 231-425-4036
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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 | 6801077151
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License Number State | MI
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