1609500503 NPI number — ASSESSMENT AND RELATIONSHIP COUNSELING CENTER LLC ARC2

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609500503 NPI number — ASSESSMENT AND RELATIONSHIP COUNSELING CENTER LLC ARC2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSESSMENT AND RELATIONSHIP COUNSELING CENTER LLC ARC2
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:
ARC2
Provider Other Organization Name Type Code:
3
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:
1609500503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
416 N HOMER ST STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48912-4700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-282-8249
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
416 N HOMER ST STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48912-4700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-282-8249
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
B
Authorized Official Middle Name:
CRAIG
Authorized Official Title or Position:
PSYCHOLOGIST, OWNER
Authorized Official Telephone Number:
517-930-5768

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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