MEDICARE: JAMIE PHILLIPS LPC, NCC

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	101Y00000X	Counselor	6401018476	MI
2	101Y00000X	Counselor	6401016189	MI

General Provider Information

NPI Number	:	1922507441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE PHILLIPS LPC, NCC

Provider Business Mailing Address
First Line	:	44060 WOODWARD AVE STE 204
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5040
Country	:	US
Telephone Number	:	248-978-2104
Fax Number	:

Provider Business Practice Location Address
First Line	:	44060 WOODWARD AVE STE 204
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5040
Country	:	US
Telephone Number	:	248-978-2104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2018
Last Update Date	:	05/15/2025

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