Provider Demographics
NPI:1407591555
Name:THROUGH THE WOODS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:THROUGH THE WOODS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOPACKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-438-3124
Mailing Address - Street 1:2090 HAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-7441
Mailing Address - Country:US
Mailing Address - Phone:616-438-3124
Mailing Address - Fax:
Practice Address - Street 1:2090 HAYFIELD DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-7441
Practice Address - Country:US
Practice Address - Phone:616-438-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty