Provider Demographics
NPI:1447885447
Name:PAWSITIVE COUNSELING CENTER PC
Entity type:Organization
Organization Name:PAWSITIVE COUNSELING CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMPSON-ROTTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-923-8568
Mailing Address - Street 1:106 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-1624
Mailing Address - Country:US
Mailing Address - Phone:231-923-8568
Mailing Address - Fax:231-722-3018
Practice Address - Street 1:106 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1624
Practice Address - Country:US
Practice Address - Phone:231-923-8568
Practice Address - Fax:231-722-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty