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NPI Code Detail

MEDICARE: MR. CHRIS A AUGUSTINE MA LPC SCL

MEDICARE: MR. CHRIS A AUGUSTINE MA LPC SCL
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
1101Y00000XCounselor6401005323MI
2101YS0200XSchool Counselor011191MI

General Provider Information

NPI Number : 1750390951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRIS A AUGUSTINE MA LPC SCL
Provider Business Mailing Address
First Line : 6040 DEVON ST
Second Line :
City : PORTAGE
State : MI
Zip : 49024-2646
Country : US
Telephone Number : 269-324-0156
Fax Number :
Provider Business Practice Location Address
First Line : 2019 RAMBLING RD
Second Line :
City : KALAMAZOO
State : MI
Zip : 49008-1630
Country : US
Telephone Number : 269-345-0909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 09/11/2025

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