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NPI Code Detail

MEDICARE: RICHMOND COUNSELING LLC

MEDICARE: RICHMOND COUNSELING 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
11041C0700XClinical Social Worker6801064001MI

General Provider Information

NPI Number : 1750862470
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHMOND COUNSELING LLC
Provider Business Mailing Address
First Line : PO BOX 10
Second Line :
City : MASON
State : MI
Zip : 48854-0010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5270 NORTHLAND DR NE STE B
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-1073
Country : US
Telephone Number : 616-514-8860
Fax Number :
Authorized Official
Title or Position : CREDENTIALING
Name : MARY BETH HOUPT
Credential :
Telephone Number : 517-676-9788
Provider Enumeration Date : 08/22/2018
Last Update Date : 12/12/2019

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Directions to “RICHMOND COUNSELING LLC ” Practice Location

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