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Organization
WATER'S EDGE COUNSELING SERVICES, LLC
Active
Organization
WATER'S EDGE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY PINNEY ELLIS MA, LPC, BCPC (CEO, THERAPIST)
(269) 214-1234
Entity
Organization
Contact information
Practice address
71901 COUNTY ROAD 388, SOUTH HAVEN, MI 49090-9336
(269) 872-3625
Mailing address
71901 COUNTY ROAD 388, SOUTH HAVEN, MI 49090-9336
(269) 872-3625
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401011487
MI
Other
Enumeration date
08/27/2016
Last updated
08/27/2016
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