Provider Demographics
NPI:1164576500
Name:WOMEN'S PERSONAL GROWTH AND PSYCHOTHERAPY CENTER, PC
Entity Type:Organization
Organization Name:WOMEN'S PERSONAL GROWTH AND PSYCHOTHERAPY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASTER SOCIAL WORKER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-347-2126
Mailing Address - Street 1:1350 HASLETT RD STE 102
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2823
Mailing Address - Country:US
Mailing Address - Phone:517-347-2126
Mailing Address - Fax:
Practice Address - Street 1:1350 HASLETT RD STE 102
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2823
Practice Address - Country:US
Practice Address - Phone:517-347-2126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty