Jonathan Michael Cugini, LMSW

Individual provider Active NPI Mental Health Counselor · Grosse Ile, MI

NPI 1073018339 · NPPES record last updated Mar 28, 2018

Key facts

NPI
1073018339
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
6801098774 (MI)
Practice address
22238 Harlan Dr
Grosse Ile, MI 48138-1476
Phone
(734) 558-6331
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6801098774MIMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801098774 MI Yes

Addresses

Primary practice location

22238 Harlan Dr
Grosse Ile, MI 48138-1476

Mailing address

22238 Harlan Dr
Grosse Ile, MI 48138-1476
Phone (734) 558-6331

Other providers in Grosse Ile, MI

All providers in Grosse Ile, MI · Mental Health Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.