| The Nurturing Space Counseling, Pllc | |
|
316 Fairlane Dr Traverse City MI 49684-4434 | |
| (231) 571-0445 | |
| Not Available |
| Full Name | The Nurturing Space Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 316 Fairlane Dr, Traverse City, Michigan |
| Authorized Official Name and Position | Melanie S. Villanueva (OWNER/ CLINICAL THERAPIST) |
| Authorized Official Contact | 2315710445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Nurturing Space Counseling, Pllc 316 Fairlane Dr Traverse City MI 49684-4434 Ph: (231) 571-0445 | The Nurturing Space Counseling, Pllc 316 Fairlane Dr Traverse City MI 49684-4434 Ph: (231) 571-0445 |
| NPI Number | 1942730387 |
|---|---|
| Provider Enumeration Date | 06/18/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0648532812 |
|---|---|
| Medicare Enrollment ID | O20180328000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942730387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Melanie S Villanueva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164821245 PECOS PAC ID: 0547522716 Enrollment ID: I20180328001003 |
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