Provider Demographics
NPI:1578744926
Name:NORTHBANK COUNSELING SERVICES, P.C.
Entity Type:Organization
Organization Name:NORTHBANK COUNSELING SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:810-750-0144
Mailing Address - Street 1:110 MILL ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2818
Mailing Address - Country:US
Mailing Address - Phone:810-750-1044
Mailing Address - Fax:
Practice Address - Street 1:110 MILL ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2818
Practice Address - Country:US
Practice Address - Phone:810-750-1044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301003045103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty