Basic Information
| Provider Information | |||||||||
| NPI: | 1578154852 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLH COUNSELING SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4058 N LINDEN RD STE C | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485041381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894136410 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4058 N LINDEN RD STE C | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485041381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894136410 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2021 | ||||||||
| LastUpdateDate: | 01/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | MILTON | ||||||||
| AuthorizedOfficialFirstName: | JAMIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9894136410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
| NPICertificationDate: | 01/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101YP2500X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.