Provider Demographics
NPI:1629897863
Name:AMAZING PEACE MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:AMAZING PEACE MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-875-1099
Mailing Address - Street 1:11870 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:LENNON
Mailing Address - State:MI
Mailing Address - Zip Code:48449-9601
Mailing Address - Country:US
Mailing Address - Phone:810-875-1099
Mailing Address - Fax:
Practice Address - Street 1:11870 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:LENNON
Practice Address - State:MI
Practice Address - Zip Code:48449-9601
Practice Address - Country:US
Practice Address - Phone:810-875-1099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty