Provider Demographics
NPI:1770992158
Name:TC MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:TC MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HELFERICH
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:231-883-2836
Mailing Address - Street 1:310 W FRONT ST
Mailing Address - Street 2:SUITE 310 A
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2279
Mailing Address - Country:US
Mailing Address - Phone:231-883-2836
Mailing Address - Fax:
Practice Address - Street 1:310 W FRONT ST
Practice Address - Street 2:SUITE 310 A
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2279
Practice Address - Country:US
Practice Address - Phone:231-883-2836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014246251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health