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NPI Code Detail

MEDICARE: CRUX LEADERSHIP COACHING, LLC

MEDICARE: CRUX LEADERSHIP COACHING, LLC
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
1101Y00000XCounselor
2104100000XSocial Worker
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1083463590
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRUX LEADERSHIP COACHING, LLC
Provider Business Mailing Address
First Line : 8149 GREEN VALLEY DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8171
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8149 GREEN VALLEY DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8171
Country : US
Telephone Number : 616-987-0883
Fax Number :
Authorized Official
Title or Position : COUNSELOR
Name : MARNEE WEISBROD
Credential : LLPC
Telephone Number : 616-987-0883
Provider Enumeration Date : 05/16/2024
Last Update Date : 08/20/2025

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Directions to “CRUX LEADERSHIP COACHING, LLC ” Practice Location

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