Provider Demographics
NPI:1508299207
Name:FOR THE FAMILY COUNSELING SERVICE PLLC
Entity Type:Organization
Organization Name:FOR THE FAMILY COUNSELING SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BUFFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:989-912-0258
Mailing Address - Street 1:4022 PARISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48470-9759
Mailing Address - Country:US
Mailing Address - Phone:989-912-0258
Mailing Address - Fax:810-539-6358
Practice Address - Street 1:3466 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DECKERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48427-7709
Practice Address - Country:US
Practice Address - Phone:989-912-0258
Practice Address - Fax:810-539-6358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010906911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty