| Fortitude Counseling Services Llc | |
|
1022 S Washington Ave Ste 3 Royal Oak MI 48067-3218 | |
| (586) 610-1108 | |
| Not Available |
| Full Name | Fortitude Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1022 S Washington Ave Ste 3, Royal Oak, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortitude Counseling Services Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Fortitude Counseling Services Llc 1022 S Washington Ave Ste 3 Royal Oak MI 48067-3218 Ph: (586) 610-1108 |
| NPI Number | 1962123893 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 3476939570 |
|---|---|
| Medicare Enrollment ID | O20220927002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962123893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Nicholas John Zielke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477070274 PECOS PAC ID: 4385020486 Enrollment ID: I20220927002199 |
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