| Counseling & Consultation Resources | |
|
720 E 8th St Suite 2 Holland MI 49423-3079 | |
| (616) 355-0549 | |
| (616) 355-0480 |
| Full Name | Counseling & Consultation Resources |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 E 8th St, Holland, Michigan |
| Authorized Official Name and Position | Brent Michael Ellens (PRESIDENT/OWNER) |
| Authorized Official Contact | 6163550549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling & Consultation Resources 720 E 8th St Suite 2 Holland MI 49423-3079 Ph: (616) 355-0549 | Counseling & Consultation Resources 720 E 8th St Suite 2 Holland MI 49423-3079 Ph: (616) 355-0549 |
| NPI Number | 1013060151 |
|---|---|
| Provider Enumeration Date | 01/20/2007 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/07/2022 |
| Medicare PECOS PAC ID | 0648663310 |
|---|---|
| Medicare Enrollment ID | O20220202001684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013060151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6301011810 (Michigan) | Primary |
| Provider Name | Brent M Ellens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932145729 PECOS PAC ID: 5799670931 Enrollment ID: I20040217000985 |
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