Provider Demographics
NPI:1851683585
Name:NORTHERN WOODS COUNSELING & CONSULTING SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHERN WOODS COUNSELING & CONSULTING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:N
Authorized Official - Last Name:PAPAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CAADC, LPC
Authorized Official - Phone:231-632-9209
Mailing Address - Street 1:109 S UNION ST STE 208
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 S UNION ST STE 208
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2575
Practice Address - Country:US
Practice Address - Phone:231-632-9209
Practice Address - Fax:231-275-7268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401000552101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1508913062OtherTYPE I NPI