MEDICARE: BLUEWATER COUNSELING AND RECOVERY

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1255944542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEWATER COUNSELING AND RECOVERY

Provider Business Mailing Address
First Line	:	2005 E BLUEWATER HWY
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-8725
Country	:	US
Telephone Number	:	616-597-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 E BLUEWATER HWY
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-8725
Country	:	US
Telephone Number	:	616-597-6080
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER/OWNER
Name	:	JASON FLOHR
Credential	:
Telephone Number	:	616-597-6080

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “BLUEWATER COUNSELING AND RECOVERY ” Practice Location

Language	Start Address	Practice Location

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