| Changing Course Counseling, Plc | |
|
3071 Commerce Dr Ste B Fort Gratiot MI 48059-3869 | |
| (810) 357-9318 | |
| (810) 479-9684 |
| Full Name | Changing Course Counseling, Plc |
|---|---|
| Speciality | Social Worker |
| Location | 3071 Commerce Dr Ste B, Fort Gratiot, Michigan |
| Authorized Official Name and Position | Kelle S Wood (LMSW/OWNER) |
| Authorized Official Contact | 8103579318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Course Counseling, Plc 4131 Fairway Dr Fort Gratiot MI 48059-3905 Ph: (810) 357-9318 | Changing Course Counseling, Plc 3071 Commerce Dr Ste B Fort Gratiot MI 48059-3869 Ph: (810) 357-9318 |
| NPI Number | 1114356649 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 8426276064 |
|---|---|
| Medicare Enrollment ID | O20140825000303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114356649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kelle S Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164465084 PECOS PAC ID: 0345422200 Enrollment ID: I20110314000733 |
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