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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