Provider Demographics
NPI:1457644981
Name:MOMENTUM COUNSELING LLC
Entity Type:Organization
Organization Name:MOMENTUM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:BIONDO
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:248-705-9263
Mailing Address - Street 1:336 S MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6702
Mailing Address - Country:US
Mailing Address - Phone:248-705-9263
Mailing Address - Fax:
Practice Address - Street 1:336 S MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-6702
Practice Address - Country:US
Practice Address - Phone:248-705-9263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty