Basic Information
| Provider Information | |||||||||
| NPI: | 1679024186 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOLY CROSS COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 CORNELL DRIVE | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174237455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8759 CLINTON MACON RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492369572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174237455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAUDOUX | ||||||||
| AuthorizedOfficialFirstName: | PAULINE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL OFFICE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9895963558 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HOLY CROSS COUNSELING SERVICES | ||||||||
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| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 6802087250 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 6802087250 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 6802087250 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 1041C0700X | 6802087250 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 106H00000X | 6802087250 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 324500000X | 6802087250 | MI | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 3245S0500X | 6802087250 | MI | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
ID Information
| ID | Type | State | Issuer | Description | 1306114814 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 1306114814 | 01 | MI | AMERIGROUP IA/MD | OTHER | 1306114814 | 01 | MI | ZELIS PAYMENTS | OTHER | 1306114814 | 01 | MI | EMPIRE | OTHER | 1306114814 | 01 | MI | ANTHEM | OTHER | 1306114814 | 01 | MI | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN | OTHER | 1306114814 | 01 | GA | BLUE CROSS AND BLUE SHIELD | OTHER | 1306114814 | 01 | MI | PAY-PLUS SOLUTIONS | OTHER | 1306114814 | 05 | SC | MEDICAID | 1306114814 | 01 | MI | GM BLUE CROSS | OTHER | 1306114814 | 01 | MI | MAPFRE LIFE | OTHER | 1306114814 | 01 | MI | AETHNA | OTHER | 1306114814 | 01 | MI | CIGNA | OTHER | 1306114814 | 05 | MI | MEDICAID |