Provider Demographics
NPI:1215195136
Name:PROFESSIONAL COUNSELING SERVICE, PLLC
Entity type:Organization
Organization Name:PROFESSIONAL COUNSELING SERVICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC, CCTP
Authorized Official - Phone:989-269-5180
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-0142
Mailing Address - Country:US
Mailing Address - Phone:989-269-5180
Mailing Address - Fax:989-269-5185
Practice Address - Street 1:128 W HURON AVE STE C
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-1177
Practice Address - Country:US
Practice Address - Phone:989-269-5180
Practice Address - Fax:989-623-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL 1121008251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health