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General NPI Number Information
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NPI Number | 1972073633
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Entity Type | Organization
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Legal Business Name | HIDDEN BROOK COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2202 MITCHELL PARK DR STE 2B
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City | PETOSKEY
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State | MI
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Zip | 49770-8897
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Country | US
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Telephone | 231-487-1885
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Fax | 231-487-1754
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Provider Business Mailing Address
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Address Line | 2202 MITCHELL PARK DR STE 2B
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City | PETOSKEY
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State | MI
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Zip | 49770-8897
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Country | US
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Telephone | 231-487-1885
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Fax | 231-487-1754
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. PRESTON GREENE
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Credential | LMSW, CAADC
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Telephone | 231-881-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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