Organization
GOGEBIC COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Active
Other names
Gogebic County Community Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TESS GREENOUGH (C.E.O.)
(906) 229-6100
Entity
Organization
Contact information
Practice address
103 W US HIGHWAY 2, WAKEFIELD, MI 49968-9515
(906) 229-6100
(906) 229-6191
Mailing address
103 W US HIGHWAY 2, WAKEFIELD, MI 49968-9515
(906) 229-6100
(906) 229-6191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1708119
—
MI
05
—
4351265
—
MI
01
—
750910818
BLUE CROSS OPC
MI
01
—
IG027143
MAGELLAN STATE OF MI GROU
MI
Enumeration date
05/10/2006
Last updated
08/30/2023
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