1558598995 NPI number — TURN THE PAGE COUNSELING SERVICES, PLLC

Table of content: (NPI 1558598995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558598995 NPI number — TURN THE PAGE COUNSELING SERVICES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TURN THE PAGE COUNSELING SERVICES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558598995
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 180817
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UTICA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48318-0817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-549-1842
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18557 CANAL RD STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48038-5821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-549-1842
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JACKSON
Authorized Official First Name:
FREDERICKA
Authorized Official Middle Name:
ARLENE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
586-549-1842

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6301008884 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1922089531 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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