MEDICARE: GUIDING STAR COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1063248185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING STAR COUNSELING PLLC

Provider Business Mailing Address
First Line	:	14215 TRALEE DR
Second Line	:
City	:	CEMENT CITY
State	:	MI
Zip	:	49233-9661
Country	:	US
Telephone Number	:	517-240-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	14215 TRALEE DR
Second Line	:
City	:	CEMENT CITY
State	:	MI
Zip	:	49233-9661
Country	:	US
Telephone Number	:	517-240-1499
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JACQULEYNN DENEAU
Credential	:	LMSW
Telephone Number	:	517-240-1499

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	09/13/2024

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