Organization
SHANTI COUNSELING SERVICES, LLC
Active
Other names
Theresa Callard-Moore, ACSW
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA MARIE CALLARD-MOORE MSW, ACSW, LMSW (PRESIDENT)
(810) 630-0904
Entity
Organization
Contact information
Practice address
6199 MILLER RD, SUITE A, SWARTZ CREEK, MI 48473-1585
(810) 630-0904
Mailing address
6199 MILLER RD, SUITE A, SWARTZ CREEK, MI 48473-1585
(810) 630-0904
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6801067098
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235158627
NPI
MI
01
—
8008976950
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/13/2007
Last updated
12/13/2007
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