Basic Information
| Provider Information | |||||||||
| NPI: | 1356709059 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPICER COUNSELING SERVICES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 860 CEDAR TRL | ||||||||
| Address2: | |||||||||
| City: | FOWLER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488359123 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1507 WATERFORD PKWY | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | SAINT JOHNS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488799630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895930211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2016 | ||||||||
| LastUpdateDate: | 02/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | SPICER | ||||||||
| AuthorizedOfficialFirstName: | MONICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9895930211 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LPC, NCC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401009273 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.