Provider Demographics
NPI:1780055194
Name:HEARTBOUND COUNSELING, PLLC
Entity type:Organization
Organization Name:HEARTBOUND COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:HOLTON
Authorized Official - Last Name:FALEER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:989-400-2367
Mailing Address - Street 1:3265 HILLTOP LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9500
Mailing Address - Country:US
Mailing Address - Phone:989-400-2367
Mailing Address - Fax:
Practice Address - Street 1:201 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2527
Practice Address - Country:US
Practice Address - Phone:989-400-2367
Practice Address - Fax:989-779-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006256251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health