Provider Demographics
NPI:1679008080
Name:COUNSELLOR CONSULTING PLC
Entity Type:Organization
Organization Name:COUNSELLOR CONSULTING PLC
Other - Org Name:THUNDER BAY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNSELLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:989-340-1755
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0787
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 HOLIDAY INN RD
Practice Address - Street 2:
Practice Address - City:HUBBARD LAKE
Practice Address - State:MI
Practice Address - Zip Code:49747-9663
Practice Address - Country:US
Practice Address - Phone:989-340-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009538101YP2500X
COLPC.0013306101YP2500X
MI7501005113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty