Provider Demographics
NPI:1922502970
Name:PALADINS PERSPECTIVE
Entity Type:Organization
Organization Name:PALADINS PERSPECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:231-233-1097
Mailing Address - Street 1:7322 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337-8702
Mailing Address - Country:US
Mailing Address - Phone:231-233-1097
Mailing Address - Fax:
Practice Address - Street 1:37 E MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1295
Practice Address - Country:US
Practice Address - Phone:231-233-1097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty