Provider Demographics
NPI:1366651721
Name:MT. PLEASANT COMMUNITY COUNSELING ASSOCIATES, PC
Entity Type:Organization
Organization Name:MT. PLEASANT COMMUNITY COUNSELING ASSOCIATES, PC
Other - Org Name:COMMUNITY COUNSELING ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLPC
Authorized Official - Phone:989-773-0222
Mailing Address - Street 1:500 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3139
Mailing Address - Country:US
Mailing Address - Phone:989-773-0222
Mailing Address - Fax:989-772-4241
Practice Address - Street 1:500 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3139
Practice Address - Country:US
Practice Address - Phone:989-773-0222
Practice Address - Fax:989-772-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty