Provider Demographics
NPI:1083463590
Name:CRUX LEADERSHIP COACHING, LLC
Entity type:Organization
Organization Name:CRUX LEADERSHIP COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARNEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISBROD
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:616-987-0883
Mailing Address - Street 1:8149 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8149 GREEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8171
Practice Address - Country:US
Practice Address - Phone:616-987-0883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty