Provider Demographics
NPI:1023054939
Name:ARLEN W. EPP MDIV, MSW, LCSW, COUNSELING AND COACHING SERVICES LLC
Entity type:Organization
Organization Name:ARLEN W. EPP MDIV, MSW, LCSW, COUNSELING AND COACHING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:EPP
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:574-262-9305
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-0384
Mailing Address - Country:US
Mailing Address - Phone:231-775-6076
Mailing Address - Fax:231-775-0027
Practice Address - Street 1:3040A WINDSOR CT
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-5555
Practice Address - Country:US
Practice Address - Phone:574-262-9305
Practice Address - Fax:574-262-9516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
233810Medicare ID - Type Unspecified