Provider Demographics
NPI:1194383323
Name:PASSERA COUNSELING, PLLC
Entity Type:Organization
Organization Name:PASSERA COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODROE-MONETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CRC,LPC
Authorized Official - Phone:734-234-8550
Mailing Address - Street 1:1113 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1289
Mailing Address - Country:US
Mailing Address - Phone:501-909-0332
Mailing Address - Fax:
Practice Address - Street 1:42327 ANN ARBOR RD E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4356
Practice Address - Country:US
Practice Address - Phone:501-909-0332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty