=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922879576
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WAYPOINT COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2024
-----------------------------------------------------
Last Update Date | 01/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 625 PINE ST
-----------------------------------------------------
City | MARQUETTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49855-3723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-250-9066
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 625 PINE ST
-----------------------------------------------------
City | MARQUETTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49855-3723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-250-9066
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELOR
-----------------------------------------------------
Name | ANDREW MITCHEL
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 906-250-9066
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------