Healthcare Provider Details

I. General information

NPI: 1972053171
Provider Name (Legal Business Name): IN HARMONY PROFESSIONAL COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N FIRST AVE SUITE 102
ALPENA MI
49707-2867
US

IV. Provider business mailing address

1136 LONG RAPIDS RD
ALPENA MI
49707-7934
US

V. Phone/Fax

Practice location:
  • Phone: 989-916-5673
  • Fax:
Mailing address:
  • Phone: 989-916-5673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401008904
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6401008904
License Number StateMI

VIII. Authorized Official

Name: LISA A DOUGLAS-LENARD
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 989-916-5673