MEDICARE: LAKEVIEW COUNSELING P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1316009012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEVIEW COUNSELING P.C.

Provider Business Mailing Address
First Line	:	1844 OAK HOLLOW DR
Second Line	:	SUITE B
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5924
Country	:	US
Telephone Number	:	231-929-0300
Fax Number	:	231-933-6378

Provider Business Practice Location Address
First Line	:	1844 OAK HOLLOW DR
Second Line	:	SUITE B
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5924
Country	:	US
Telephone Number	:	231-929-0300
Fax Number	:	231-933-6378

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. CAROL ANN MURRAY
Credential	:	MSW
Telephone Number	:	231-929-0300

Provider Enumeration Date	:	12/16/2006
Last Update Date	:	05/23/2011

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