Healthcare Provider Details

I. General information

NPI: 1467054320
Provider Name (Legal Business Name): LOO GEN SEAH MCCREA LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOO GEN SEAH-MCCREA LPC, NCC

II. Dates (important events)

Enumeration Date: 11/14/2020
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 S STATE ST STE 200
ANN ARBOR MI
48104-6184
US

IV. Provider business mailing address

519 EASTLOOK DR
SALINE MI
48176-1556
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-0209
  • Fax:
Mailing address:
  • Phone: 734-276-2707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401017499
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401019671
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: