Changing Course Counseling, PLC
Organization Active NPI Clinical Social Worker · Fort Gratiot, MI
NPI 1114356649 · NPPES record last updated Aug 7, 2024
Key facts
- NPI
- 1114356649
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- CHANGING COURSE COUNSELING, PLC
- Practice address
- 3071 Commerce Dr Ste B
Fort Gratiot, MI 48059-3869 - Phone
- (810) 357-9318
- Fax
- (810) 479-9684
- NPI assigned
- Nov 5, 2013
- Organization subpart
- No
Authorized official
- Name
- Kelle S Wood, LMSW
- Title
- LMSW/Owner
- Phone
- (810) 357-9318
Practitioners 2
-
Kelle S Wood, LMSW
-
Shari Smith, MA, LPC, NCC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140825000303 | MI | Part B Supplier - Clinic/Group Practice | 8426276064 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Gratiot, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X |
Addresses
Primary practice location
3071 Commerce Dr Ste B
Fort Gratiot, MI 48059-3869
Mailing address
4131 Fairway Dr
Fort Gratiot, MI 48059-3905
Phone (810) 357-9318
Other providers in Fort Gratiot, MI
- Cara Dawn Cantrell X
- Carepoint Solutions
- Vil Edward Matro Castillo
- Helene Ann Castle
- Cindy Chalfant
- Amanda Chehab
- Leela Cherian
- Jenna Chilcutt
- Asa Choate
- Nicole Churchill
All providers in Fort Gratiot, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.