Provider Demographics
NPI:1265017917
Name:WANDERING PATH COUNSELING, LLC
Entity Type:Organization
Organization Name:WANDERING PATH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-574-9296
Mailing Address - Street 1:7332 JOCHAR RD
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:MI
Mailing Address - Zip Code:48001-3021
Mailing Address - Country:US
Mailing Address - Phone:586-500-8080
Mailing Address - Fax:586-500-8070
Practice Address - Street 1:7312 JOCHAR RD
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:MI
Practice Address - Zip Code:48001-3021
Practice Address - Country:US
Practice Address - Phone:313-574-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1265017917OtherTYPE 2 NPI