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NPI Code Detail

MEDICARE: SSM COUNSELING GROUP PLLC

MEDICARE: SSM COUNSELING GROUP 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1669270054
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSM COUNSELING GROUP PLLC
Provider Business Mailing Address
First Line : 2810 FEATHER GREEN TRL
Second Line :
City : FRESNO
State : TX
Zip : 77545-7152
Country : US
Telephone Number : 281-235-2375
Fax Number :
Provider Business Practice Location Address
First Line : 2810 FEATHER GREEN TRL
Second Line :
City : FRESNO
State : TX
Zip : 77545-7152
Country : US
Telephone Number : 281-235-2375
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : SHEMISE MICHAEL
Credential : LPC
Telephone Number : 281-235-2375
Provider Enumeration Date : 03/03/2025
Last Update Date : 03/03/2025

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