MEDICARE: COUNSELING SERVICES P.C.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649543646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING SERVICES P.C.

Provider Business Mailing Address
First Line	:	24225 W 9 MILE RD
Second Line	:	SUITE 114
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3962
Country	:	US
Telephone Number	:	248-352-8841
Fax Number	:

Provider Business Practice Location Address
First Line	:	24225 W 9 MILE RD
Second Line	:	SUITE 114
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3962
Country	:	US
Telephone Number	:	248-352-8841
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. D BENNING
Credential	:
Telephone Number	:	248-352-8841

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

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