Provider Demographics
NPI:1679024186
Name:HOLY CROSS COUNSELING SERVICES
Entity Type:Organization
Organization Name:HOLY CROSS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-596-3558
Mailing Address - Street 1:444 CORNELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017
Mailing Address - Country:US
Mailing Address - Phone:517-423-7455
Mailing Address - Fax:
Practice Address - Street 1:8759 CLINTON MACON RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MI
Practice Address - Zip Code:49236-9572
Practice Address - Country:US
Practice Address - Phone:517-423-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLY CROSS COUNSELING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802087250101YA0400X, 101YM0800X, 101YP2500X, 1041C0700X, 106H00000X, 324500000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1306114814OtherBLUE CROSS BLUE SHIELD
MI1306114814OtherAMERIGROUP IA/MD
MI1306114814OtherZELIS PAYMENTS
MI1306114814OtherEMPIRE
MI1306114814OtherANTHEM
MI1306114814OtherCAPITAL DISTRICT PHYSICIANS' HEALTH PLAN
GA1306114814OtherBLUE CROSS AND BLUE SHIELD
MI1306114814OtherPAY-PLUS SOLUTIONS
SC1306114814Medicaid
MI1306114814OtherGM BLUE CROSS
MI1306114814OtherMAPFRE LIFE
MI1306114814OtherAETHNA
MI1306114814OtherCIGNA
MI1306114814Medicaid