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General NPI Number Information
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NPI Number | 1902382856
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Entity Type | Organization
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Legal Business Name | GIESKEN COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 5840 LORAC DR
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City | CLARKSTON
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State | MI
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Zip | 48346-2915
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Country | US
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Telephone | 989-397-0617
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Fax |
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Provider Business Mailing Address
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Address Line | 8453 HORTON RD
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City | GOODRICH
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State | MI
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Zip | 48438-9487
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Country | US
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Telephone | 989-397-0617
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | JERILYNN JACOBSON
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Credential | LMSW
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Telephone | 989-397-0617
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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 | 6801091509
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License Number State | MI
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