Provider Demographics
NPI:1003318353
Name:DOWNTOWN COUNSELING AND ASSESSMENTS
Entity Type:Organization
Organization Name:DOWNTOWN COUNSELING AND ASSESSMENTS
Other - Org Name:COPE PERSONAL DEVELOPMENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CONIC
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD
Authorized Official - Phone:989-245-4131
Mailing Address - Street 1:100 S JEFFERSON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1267
Mailing Address - Country:US
Mailing Address - Phone:989-752-6319
Mailing Address - Fax:989-752-0895
Practice Address - Street 1:100 S JEFFERSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1267
Practice Address - Country:US
Practice Address - Phone:989-752-6319
Practice Address - Fax:989-752-0895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COPE PERSONAL DEVELOPMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003666251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health