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General NPI Number Information
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NPI Number | 1700333697
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Entity Type | Organization
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Legal Business Name | COUNSELING ASSOCIATES OF NORTHERN MICHIGAN PLLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 121 N MITCHELL ST
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City | CADILLAC
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State | MI
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Zip | 49601-1879
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Country | US
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Telephone | 231-360-5447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OUT PATIENT THERAPIST
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Name | MRS. KAREN MARIE CHITWOOD
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Credential | LMSW
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Telephone | 231-360-5447
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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 | 6801090710
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License Number State | MI
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