Provider Demographics
NPI:1427500594
Name:HELLCAT COUNSELING, PLLC
Entity type:Organization
Organization Name:HELLCAT COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:AVERY-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:269-240-7788
Mailing Address - Street 1:609 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1318
Mailing Address - Country:US
Mailing Address - Phone:269-240-7788
Mailing Address - Fax:
Practice Address - Street 1:609 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1318
Practice Address - Country:US
Practice Address - Phone:269-240-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014792101Y00000X
MI6301007536103TC1900X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty