Provider Demographics
NPI:1689200297
Name:FUSION CONSULTING & MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:FUSION CONSULTING & MENTAL HEALTH SERVICES, LLC
Other - Org Name:FCMHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:R
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-916-4881
Mailing Address - Street 1:550 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2645
Mailing Address - Country:US
Mailing Address - Phone:810-660-8686
Mailing Address - Fax:810-788-1043
Practice Address - Street 1:550 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2645
Practice Address - Country:US
Practice Address - Phone:810-255-0888
Practice Address - Fax:810-788-1043
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FUSION CONSULTING & MENTAL HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-15
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty