Provider Demographics
NPI:1366879231
Name:CHRISTIAN COUNSELING OF MID MICHIGAN
Entity type:Organization
Organization Name:CHRISTIAN COUNSELING OF MID MICHIGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-317-4664
Mailing Address - Street 1:904 E PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3921
Mailing Address - Country:US
Mailing Address - Phone:989-317-4664
Mailing Address - Fax:989-317-3418
Practice Address - Street 1:904 E PRESTON RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3921
Practice Address - Country:US
Practice Address - Phone:989-317-4664
Practice Address - Fax:989-317-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty