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Organization
PORTAGE COUNSELING AND COACHING
Active
Organization
PORTAGE COUNSELING AND COACHING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD BROOKS (OWNER)
(269) 998-8183
Entity
Organization
Contact information
Practice address
10032 SHAVER RD, PORTAGE, MI 49024-6738
(269) 998-8183
Mailing address
5380 HOLIDAY TER STE 32, KALAMAZOO, MI 49009-2128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/27/2019
Last updated
07/27/2019
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