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General NPI Number Information
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NPI Number | 1679049746
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Entity Type | Organization
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Legal Business Name | SEBALY COUNSELING SERVICES
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Dates
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Enumeration Date | 10/16/2018
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 102 W WASHINGTON ST
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City | MARQUETTE
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State | MI
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Zip | 49855-4368
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Country | US
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Telephone | 906-428-6881
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Fax |
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Provider Business Mailing Address
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Address Line | 2438 DIVISION ST APT 5
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City | MARQUETTE
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State | MI
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Zip | 49855-8813
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Country | US
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Telephone | 906-428-6881
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ELSA DENISE GALLIPPO-SEBALY
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Credential |
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Telephone | 906-428-6881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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