Provider Demographics
NPI:1912335068
Name:COUNSELING WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:COUNSELING WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:PRETZER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:586-994-8800
Mailing Address - Street 1:46270 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-6236
Mailing Address - Country:US
Mailing Address - Phone:586-994-8800
Mailing Address - Fax:586-737-7057
Practice Address - Street 1:47100 SCHOENHERR RD
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-4716
Practice Address - Country:US
Practice Address - Phone:586-994-8800
Practice Address - Fax:586-737-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty