Provider Demographics
NPI:1538107008
Name:INSTITUTE FOR CHRISTIAN COUNSELING PC
Entity Type:Organization
Organization Name:INSTITUTE FOR CHRISTIAN COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:VARANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:810-629-8179
Mailing Address - Street 1:12470 MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-8856
Mailing Address - Country:US
Mailing Address - Phone:810-629-8179
Mailing Address - Fax:
Practice Address - Street 1:12470 MARGARET DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-8856
Practice Address - Country:US
Practice Address - Phone:810-629-8179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301004055103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty