Provider Demographics
NPI:1801349303
Name:COUNSELING CENTERS OF MICHIGAN
Entity type:Organization
Organization Name:COUNSELING CENTERS OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/ CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-707-6480
Mailing Address - Street 1:7300 DIXIE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-5102
Mailing Address - Country:US
Mailing Address - Phone:248-707-6480
Mailing Address - Fax:248-707-6481
Practice Address - Street 1:7300 DIXIE HWY STE 300
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-5102
Practice Address - Country:US
Practice Address - Phone:248-707-6480
Practice Address - Fax:248-707-6481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090542251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health