Provider Demographics
NPI:1629467725
Name:ALTERNATIVE COUNSELING SERVICES
Entity Type:Organization
Organization Name:ALTERNATIVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PROCHAZKA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-776-0676
Mailing Address - Street 1:7950 JENNINGS RD
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9511
Mailing Address - Country:US
Mailing Address - Phone:734-776-0676
Mailing Address - Fax:
Practice Address - Street 1:2035 HOGBACK RD
Practice Address - Street 2:STE 210
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9732
Practice Address - Country:US
Practice Address - Phone:734-776-0676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801005822251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health