| Urban Counseling, Pllc | |
|
1538 Tamarack Ave Nw Grand Rapids MI 49504-3041 | |
| (810) 334-0506 | |
| Not Available |
| Full Name | Urban Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1538 Tamarack Ave Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Breeyn Nicole Maxwell (THERAPIST/OWNER) |
| Authorized Official Contact | 8103340506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urban Counseling, Pllc 1538 Tamarack Ave Nw Grand Rapids MI 49504-3041 Ph: (810) 334-0506 | Urban Counseling, Pllc 1538 Tamarack Ave Nw Grand Rapids MI 49504-3041 Ph: (810) 334-0506 |
| NPI Number | 1538940291 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Medicare PECOS PAC ID | 2860831187 |
|---|---|
| Medicare Enrollment ID | O20240419001406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538940291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Breeyn Maxwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558747055 PECOS PAC ID: 4587003702 Enrollment ID: I20240419001903 |
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