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Organization
THERAPY APP
Active
Organization
THERAPY APP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY NOLAN CHICOSKI LMSW (CO-FOUNDER/ THERAPIST)
(269) 873-7617
Entity
Organization
Contact information
Practice address
1651 W CENTRE AVE, SUITE 209, PORTAGE, MI 49024-6312
(269) 873-7617
Mailing address
1651 W CENTRE AVE, SUITE 209, PORTAGE, MI 49024-6312
(269) 873-7617
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
6801090171
MI
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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