Provider Demographics
NPI:1750122768
Name:1308 COUNSELING LLC
Entity type:Organization
Organization Name:1308 COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:PEETERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:517-775-7211
Mailing Address - Street 1:1422 W SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2434
Mailing Address - Country:US
Mailing Address - Phone:734-249-8341
Mailing Address - Fax:
Practice Address - Street 1:1422 W SAGINAW ST
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2434
Practice Address - Country:US
Practice Address - Phone:734-249-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty