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General NPI Number Information
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NPI Number | 1972773182
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Entity Type | Organization
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Legal Business Name | INTERPRETIVE ARTS COUNSELING LLC
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 148 NORTH RIVERVIEW DRIVE
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City | PARCHMENT
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State | MI
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Zip | 49004
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Country | US
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Telephone | 269-382-5343
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Fax | 269-226-0748
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Provider Business Mailing Address
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Address Line | 148 NORTH RIVERVIEW DRIVE PO BOX 188
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City | PARCHMENT
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State | MI
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Zip | 49004
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Country | US
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Telephone | 269-382-5343
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Fax | 269-226-0748
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Authorized Official
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Title or Position | PSYCHOLOGIST PROFESSIONAL COUNSELOR
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Name | MS. SHARON CIPRIANO GIALBREATH
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Credential | LLP LLPC LSW LPN
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Telephone | 269-382-5343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401009506
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801063816
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703015679
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301009159
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License Number State | MI
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