Provider Demographics
NPI:1619907052
Name:CATHOLIC SOCIAL SERVICES OF THE U.P.
Entity Type:Organization
Organization Name:CATHOLIC SOCIAL SERVICES OF THE U.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FEATHERSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-227-9118
Mailing Address - Street 1:347 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4725
Mailing Address - Country:US
Mailing Address - Phone:906-227-9118
Mailing Address - Fax:906-228-2469
Practice Address - Street 1:347 ROCK ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4725
Practice Address - Country:US
Practice Address - Phone:906-227-9118
Practice Address - Fax:906-228-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5200561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7509106790OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509106440OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509105340OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509105360OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509106980OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509105520OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7509106980OtherBLUE CROSS BLUE SHIELD OF MICHIGAN