Provider Demographics
NPI:1215395850
Name:ZOE COUNSELING AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:ZOE COUNSELING AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERNESTINE
Authorized Official - Middle Name:KIMBERLY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC
Authorized Official - Phone:810-982-8144
Mailing Address - Street 1:3003 MOAK ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6845
Mailing Address - Country:US
Mailing Address - Phone:810-982-8144
Mailing Address - Fax:
Practice Address - Street 1:3003 MOAK ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6845
Practice Address - Country:US
Practice Address - Phone:810-982-8144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086434251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154420552Medicare NSC