Provider Demographics
NPI:1497913768
Name:CANCER COUNSELING, L.L.C.
Entity Type:Organization
Organization Name:CANCER COUNSELING, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:248-521-0982
Mailing Address - Street 1:4673 PIER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4180
Mailing Address - Country:US
Mailing Address - Phone:248-521-0982
Mailing Address - Fax:248-641-3064
Practice Address - Street 1:4673 PIER DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4180
Practice Address - Country:US
Practice Address - Phone:248-521-0982
Practice Address - Fax:248-641-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704126237261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health