Provider Demographics
NPI:1023636511
Name:NORTH STAR PROFESSIONAL COUNSELING PLLC
Entity type:Organization
Organization Name:NORTH STAR PROFESSIONAL COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLPC
Authorized Official - Phone:810-844-1850
Mailing Address - Street 1:1697 CLOVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8081
Mailing Address - Country:US
Mailing Address - Phone:810-844-1850
Mailing Address - Fax:
Practice Address - Street 1:1697 CLOVER RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8081
Practice Address - Country:US
Practice Address - Phone:810-923-8861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)