Organization
COUNSELING ASSOCIATES, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX J. GROSSBERG (CREDENTIALING COORDINATOR)
(248) 626-1500
Entity
Organization
Contact information
Practice address
6960 ORCHARD LAKE RD, 100, WEST BLOOMFIELD, MI 48322-4515
(248) 626-1500
Mailing address
6960 ORCHARD LAKE RD, 100, WEST BLOOMFIELD, MI 48322-4515
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P11960
MEDICARE PTAN FOR MDS
—
01
—
0P12130
MEDICARE PTAN FOR PHDS
—
01
—
0P12140
MEDICARE PTAN FOR MSWS
—
05
—
1175880
—
MI
Enumeration date
12/14/2015
Last updated
12/14/2015
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