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Organization
INDIGO CREEK COUNSELING CENTER, LLC
Active
Organization
INDIGO CREEK COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY MENZEL LMSW (OWNER)
(906) 281-4852
Entity
Organization
Contact information
Practice address
200 MICHIGAN ST, STE 308, HANCOCK, MI 49930-1427
(906) 281-4852
Mailing address
200 MICHIGAN ST, STE 308, HANCOCK, MI 49930-1427
(906) 281-4852
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801067833
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6801067833
—
MI
01
—
OP40990
MEDICARE
MI
Enumeration date
11/29/2011
Last updated
11/29/2011
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