Provider Demographics
NPI:1326406018
Name:WINK COUNSELING SERVICES PC
Entity Type:Organization
Organization Name:WINK COUNSELING SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:WINKE
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:248-885-5007
Mailing Address - Street 1:2701 TROY CENTER DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4753
Mailing Address - Country:US
Mailing Address - Phone:248-885-5007
Mailing Address - Fax:
Practice Address - Street 1:2701 TROY CENTER DR
Practice Address - Street 2:SUITE 255
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4753
Practice Address - Country:US
Practice Address - Phone:248-885-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801098377251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health