Blue Water Healing Clinic Llc

Specialty details in registry · Jackson, MI

Call (734) 273-9681 Directions

At a glance

1902 4Th St, Jackson, MI 49203-4040

NPPES record updated May 21, 2025. Public records can lag behind changes at a practice.

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Practice location

1902 4Th St
Jackson, MI 49203-4040

Professional details: NPI, taxonomy & registry record

NPI1861284267

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 101YP2500X
Enumeration date: May 21, 2025
Record updated: May 21, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

101YP2500X · Primary

Specialty details in registry

104100000X

Clinical Social Worker

1041C0700X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1902 4Th St
Jackson, MI 49203-4040

Phone: (734) 273-9681

Mailing address

2902 LITTLE ST

PORT HURON, MI 480606829

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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