Country-Side Counseling & Consultation Services, PC

Organization Active NPI Mental Health Counselor · Fruitport, MI

NPI 1184940751 · NPPES record last updated Oct 27, 2016

Key facts

NPI
1184940751
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
COUNTRY-SIDE COUNSELING & CONSULTATION SERVICES, PC
Practice address
388 N 3Rd Ave
Suite F
Fruitport, MI 49415-9785
Phone
(231) 571-0082
NPI assigned
Apr 8, 2010
Organization subpart
No

Authorized official

Name
Mr. Roger Dale Bayne, L.P.C
Title
President
Phone
(231) 571-0082

National Provider Directory

Locations

388 N 3rd Ave
Ste F
Fruitport, MI 49415
Phone (231) 206-4066

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

388 N 3Rd Ave
Suite F
Fruitport, MI 49415-9785

Mailing address

388 N 3Rd Ave
Suite F
Fruitport, MI 49415-9785
Phone (231) 571-0082

Other providers in Fruitport, MI

All providers in Fruitport, MI · Mental Health Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.