Provider Demographics
NPI:1699709717
Name:SEASONS COUNSELING CENTER PC
Entity type:Organization
Organization Name:SEASONS COUNSELING CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:P
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-975-8106
Mailing Address - Street 1:7382 MOHANSIC DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3552
Mailing Address - Country:US
Mailing Address - Phone:248-975-8106
Mailing Address - Fax:
Practice Address - Street 1:8311 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2000
Practice Address - Country:US
Practice Address - Phone:810-606-1099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty