Provider Demographics
NPI:1053617225
Name:NORTHSTAR COUNSELING AND HERBALS LLC
Entity type:Organization
Organization Name:NORTHSTAR COUNSELING AND HERBALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DREWS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-587-5632
Mailing Address - Street 1:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:MANCELONA
Mailing Address - State:MI
Mailing Address - Zip Code:49659-0501
Mailing Address - Country:US
Mailing Address - Phone:231-587-5632
Mailing Address - Fax:
Practice Address - Street 1:321 E LAKE ST
Practice Address - Street 2:SUITE #2
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2478
Practice Address - Country:US
Practice Address - Phone:231-392-6957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801080915261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)