| Starboard Counseling Llc | |
|
3923 Essex Pl Fort Gratiot MI 48059-3762 | |
| (406) 480-6070 | |
| Not Available |
| Full Name | Starboard Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3923 Essex Pl, Fort Gratiot, Michigan |
| Authorized Official Name and Position | Christopher Douglas Mullin (SOLE MEMBER) |
| Authorized Official Contact | 4064806070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Starboard Counseling Llc 3923 Essex Pl Fort Gratiot MI 48059-3762 Ph: (406) 480-6070 | Starboard Counseling Llc 3923 Essex Pl Fort Gratiot MI 48059-3762 Ph: (406) 480-6070 |
| NPI Number | 1134901481 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 2961847629 |
|---|---|
| Medicare Enrollment ID | O20240304003136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134901481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christopher D Mullin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336328442 PECOS PAC ID: 1557591112 Enrollment ID: I20140226001286 |
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