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Organization
TELETHERAPY GROUP, LLC
Active
Organization
TELETHERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAITLIN BUDER (AO)
(269) 808-1818
Entity
Organization
Contact information
Practice address
1111 W CENTRE AVE, PORTAGE, MI 49024-5317
(269) 366-0650
(269) 762-5957
Mailing address
1111 W CENTRE AVE, PORTAGE, MI 49024-5317
(269) 366-0650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
06/08/2017
Last updated
02/23/2024
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