Provider Demographics
NPI:1871366583
Name:FELLOWS COUNSELING & CONSULTING
Entity type:Organization
Organization Name:FELLOWS COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LMHC
Authorized Official - Phone:269-697-1673
Mailing Address - Street 1:324 E DEWEY ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1494
Mailing Address - Country:US
Mailing Address - Phone:269-697-1673
Mailing Address - Fax:269-666-6577
Practice Address - Street 1:324 E DEWEY ST STE 204
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1494
Practice Address - Country:US
Practice Address - Phone:269-697-1673
Practice Address - Fax:269-666-6577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)