Provider Demographics
NPI:1750019881
Name:CARPE CHRISTUM COUNSELING LLC
Entity type:Organization
Organization Name:CARPE CHRISTUM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DIEM
Authorized Official - Middle Name:T
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CADC
Authorized Official - Phone:651-354-1372
Mailing Address - Street 1:5697 NELSON DR
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-7580
Mailing Address - Country:US
Mailing Address - Phone:651-354-1372
Mailing Address - Fax:
Practice Address - Street 1:853 SILVER LEASE ST SE
Practice Address - Street 2:
Practice Address - City:KENWOOD
Practice Address - State:MI
Practice Address - Zip Code:45908
Practice Address - Country:US
Practice Address - Phone:651-354-1372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty