Provider Demographics
NPI:1003633645
Name:NORTHERN STAR COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:NORTHERN STAR COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-362-4529
Mailing Address - Street 1:308 CLEVELAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-1837
Mailing Address - Country:US
Mailing Address - Phone:906-362-4174
Mailing Address - Fax:
Practice Address - Street 1:308 CLEVELAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-1837
Practice Address - Country:US
Practice Address - Phone:906-362-4174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty