Basic Information
Provider Information
NPI: 1912328956
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARBOWSKI
FirstName: ERIC
MiddleName: RAYMOND
NamePrefix:  
NameSuffix:  
Credential: M.A., E.S.T., QMHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 S CRAPO ST STE 200
Address2:  
City: MT PLEASANT
State: MI
PostalCode: 488582941
CountryCode: US
TelephoneNumber: 9897725938
FaxNumber:  
Practice Location
Address1: 301 S CRAPO ST STE 200
Address2:  
City: MT PLEASANT
State: MI
PostalCode: 488582941
CountryCode: US
TelephoneNumber: 9897725938
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/18/2013
LastUpdateDate: 12/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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