Provider Demographics
NPI:1730272485
Name:ST. JOHNS COUNSELING AND THERAPY SERVICES, P.C.
Entity type:Organization
Organization Name:ST. JOHNS COUNSELING AND THERAPY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LMSW, ACSW
Authorized Official - Phone:989-227-9000
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:1505 WATERFORD PARKWAY
Mailing Address - City:ST. JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879
Mailing Address - Country:US
Mailing Address - Phone:989-227-9000
Mailing Address - Fax:989-224-0058
Practice Address - Street 1:1505 WATERFORD PARKWAY
Practice Address - Street 2:
Practice Address - City:ST. JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879
Practice Address - Country:US
Practice Address - Phone:989-227-9000
Practice Address - Fax:989-224-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty