Basic Information
| Provider Information | |||||||||
| NPI: | 1518521277 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HELLWIG THERAPY SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2145 UNIVERSITY PARK DR STE 365 | ||||||||
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| City: | OKEMOS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488643982 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 2145 UNIVERSITY PARK DR STE 365 | ||||||||
| Address2: | |||||||||
| City: | OKEMOS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488643982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174497838 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2019 | ||||||||
| LastUpdateDate: | 03/31/2020 | ||||||||
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| AuthorizedOfficialLastName: | HELLWIG | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9897230732 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.