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General NPI Number Information
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NPI Number | 1952969370
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Entity Type | Organization
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Legal Business Name | PREMIER COUNSELING AND WELLNESS INSTITUTE
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 780 W LAKE LANSING RD STE 100
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City | EAST LANSING
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State | MI
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Zip | 48823-8452
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Country | US
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Telephone | 517-618-0579
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1494
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City | OKEMOS
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State | MI
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Zip | 48805-1494
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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 | MANAGER
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Name | KILEY SHILLING
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Credential |
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Telephone | 517-231-3962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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