Provider Demographics
NPI:1417592122
Name:RECORE COUNSELING AND CONSULTING, INC
Entity Type:Organization
Organization Name:RECORE COUNSELING AND CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:616-405-4188
Mailing Address - Street 1:17214 VAN WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9780
Mailing Address - Country:US
Mailing Address - Phone:616-405-4188
Mailing Address - Fax:
Practice Address - Street 1:17214 VAN WAGONER RD
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9780
Practice Address - Country:US
Practice Address - Phone:616-405-4188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty