Provider Demographics
NPI:1184927865
Name:DELNAT, AUTUMN BROOKE (MA, LPC, CSAYC)
Entity type:Individual
Prefix:MISS
First Name:AUTUMN
Middle Name:BROOKE
Last Name:DELNAT
Suffix:
Gender:F
Credentials:MA, LPC, CSAYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 1/2 PORTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-1527
Mailing Address - Country:US
Mailing Address - Phone:269-816-3070
Mailing Address - Fax:
Practice Address - Street 1:30 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093
Practice Address - Country:US
Practice Address - Phone:269-858-9959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013610101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional