Provider Demographics
NPI:1629898549
Name:GOLD STAR COUNSELING LLC
Entity type:Organization
Organization Name:GOLD STAR COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-533-3775
Mailing Address - Street 1:414 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1224
Mailing Address - Country:US
Mailing Address - Phone:248-533-3775
Mailing Address - Fax:
Practice Address - Street 1:414 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1224
Practice Address - Country:US
Practice Address - Phone:248-533-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health