Provider Demographics
NPI:1407539851
Name:NOMI COUNSELING AND ASSESSMENT SERVICES
Entity type:Organization
Organization Name:NOMI COUNSELING AND ASSESSMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:GILLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:231-886-8295
Mailing Address - Street 1:1821 W HOUGHTON LAKE DR STE C
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9388
Mailing Address - Country:US
Mailing Address - Phone:231-886-8295
Mailing Address - Fax:
Practice Address - Street 1:1821 W HOUGHTON LAKE DR STE C
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-9388
Practice Address - Country:US
Practice Address - Phone:231-886-8295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)