Provider Demographics
NPI:1619112836
Name:WALINSKI, MITCHELL B (MA, LLPC, CAAC)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:B
Last Name:WALINSKI
Suffix:
Gender:M
Credentials:MA, LLPC, CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 E ROSE RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9751
Mailing Address - Country:US
Mailing Address - Phone:517-462-6642
Mailing Address - Fax:269-993-4264
Practice Address - Street 1:200 ORLEANS BLVD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1767
Practice Address - Country:US
Practice Address - Phone:517-462-6642
Practice Address - Fax:269-993-4264
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084115171M00000X
MI6401010969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator