Organization
COLLABORATIVE COUNSELING AND SUPERVISION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY FITZPATRICK (OWNER)
(616) 808-1965
Entity
Organization
Contact information
Practice address
3209 W NELSON ST, MIDLAND, MI 48640-3303
(616) 808-1965
Mailing address
3209 W NELSON ST, MIDLAND, MI 48640-3303
(616) 808-1965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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