Provider Demographics
NPI:1962115188
Name:PATH OF PEACE COUNSELING, LLC
Entity type:Organization
Organization Name:PATH OF PEACE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF GROUP
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALDERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-412-8471
Mailing Address - Street 1:1621 N SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1548
Mailing Address - Country:US
Mailing Address - Phone:810-412-8471
Mailing Address - Fax:
Practice Address - Street 1:1621 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1548
Practice Address - Country:US
Practice Address - Phone:810-412-8471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty