Provider Demographics
NPI:1972773182
Name:INTERPRETIVE ARTS COUNSELING LLC
Entity Type:Organization
Organization Name:INTERPRETIVE ARTS COUNSELING LLC
Other - Org Name:SHARON CIPRIANO GIALBREATH MA
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:CIPRIANO
Authorized Official - Last Name:GIALBREATH
Authorized Official - Suffix:
Authorized Official - Credentials:LLP LLPC LSW LPN
Authorized Official - Phone:269-382-5343
Mailing Address - Street 1:148 NORTH RIVERVIEW DRIVE
Mailing Address - Street 2:PO BOX 188
Mailing Address - City:PARCHMENT
Mailing Address - State:MI
Mailing Address - Zip Code:49004
Mailing Address - Country:US
Mailing Address - Phone:269-382-5343
Mailing Address - Fax:269-226-0748
Practice Address - Street 1:148 NORTH RIVERVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:PARCHMENT
Practice Address - State:MI
Practice Address - Zip Code:49004
Practice Address - Country:US
Practice Address - Phone:269-382-5343
Practice Address - Fax:269-226-0748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009506101Y00000X
MI6301009159103T00000X
MI6801063816104100000X
MI4703015679164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9899390OtherDHS
MI7484OtherKCMH