1679830681 NPI number — WORDS OF ENCOURAGEMENT COUNSELING AGENCY PC

Table of content: (NPI 1679830681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679830681 NPI number — WORDS OF ENCOURAGEMENT COUNSELING AGENCY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WORDS OF ENCOURAGEMENT COUNSELING AGENCY PC
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:
1679830681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2522 WINONA ST
Provider Second Line Business Mailing Address:
P O BOX 13537 FLINT, MI 48501
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48504-2774
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-233-8764
Provider Business Mailing Address Fax Number:
810-230-8459

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
G3500 FLUSHING RD
Provider Second Line Business Practice Location Address:
SUITE #112
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48504-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-230-8617
Provider Business Practice Location Address Fax Number:
810-230-8459
Provider Enumeration Date:
04/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
RETT
Authorized Official First Name:
FERD
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
810-230-8459

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  1041C0700X , 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)





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