Provider Demographics
NPI:1639188709
Name:ADDICTION SOLUTIONS COUNSELING
Entity Type:Organization
Organization Name:ADDICTION SOLUTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LMSW, CAAC
Authorized Official - Phone:989-779-9449
Mailing Address - Street 1:218 S. WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2409
Mailing Address - Country:US
Mailing Address - Phone:989-779-9449
Mailing Address - Fax:989-779-2922
Practice Address - Street 1:218 S. WASHINGTON
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2409
Practice Address - Country:US
Practice Address - Phone:989-779-9449
Practice Address - Fax:989-779-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-00728101YA0400X
MI68010842261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1705289Medicaid
MI11581843Medicare UPIN
MI1705289Medicaid