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General NPI Number Information
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NPI Number | 1588356596
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Entity Type | Organization
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Legal Business Name | BEACON COUNSELING UNITED
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 34617 NANCY ST
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City | WESTLAND
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State | MI
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Zip | 48186-4394
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Country | US
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Telephone | 248-599-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 34617 NANCY ST
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City | WESTLAND
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State | MI
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Zip | 48186-4394
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Country | US
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Telephone | 248-599-2213
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | LARA POMNITZ
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Credential | LMSW, BSW
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Telephone | 248-599-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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