Blue Water Mental Health Clinic

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Fort Gratiot, MI

NPI 1174924864 · NPPES record last updated Sep 12, 2014

Key facts

NPI
1174924864
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
BLUE WATER MENTAL HEALTH CLINIC
Practice address
1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone
(810) 985-5125
Fax
(810) 985-5127
NPI assigned
Sep 12, 2014
Organization subpart
No

Authorized official

Name
Linda A Liethen
Title
Executive Director
Phone
(810) 985-5125

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC0700X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

1501 Krafft Rd
Fort Gratiot, MI 48059-3565

Mailing address

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

Other names

  • Blue Water Counseling Doing business as

Other providers in Fort Gratiot, MI

All providers in Fort Gratiot, MI · Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

Sources for this page

Verify at the official NPI Registry.