Provider Demographics
NPI:1295946572
Name:INTEGRITY COUNSELING AND CENTER FOR DEVELOPMENT, PC.
Entity type:Organization
Organization Name:INTEGRITY COUNSELING AND CENTER FOR DEVELOPMENT, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:COREY
Authorized Official - Last Name:SERAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-423-5348
Mailing Address - Street 1:115 N MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1528
Mailing Address - Country:US
Mailing Address - Phone:517-423-5348
Mailing Address - Fax:
Practice Address - Street 1:136 W CHICAGO BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1553
Practice Address - Country:US
Practice Address - Phone:517-423-5348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1457577843OtherNATIONAL PROVIDER ID
MI1073739462OtherNATIONAL PROVIDER ID