Provider Demographics
NPI:1114545944
Name:OUTSIDE OF THE BOX COUNSELING SERVICES
Entity Type:Organization
Organization Name:OUTSIDE OF THE BOX COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY-KOURT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-489-9729
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48844-2400
Mailing Address - Country:US
Mailing Address - Phone:734-489-9729
Mailing Address - Fax:
Practice Address - Street 1:3744 AMBER OAKS DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48855-7108
Practice Address - Country:US
Practice Address - Phone:517-304-1326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health