Healthcare Provider Details

I. General information

NPI: 1962185587
Provider Name (Legal Business Name): COMPASSIONATE COUNSELING OF MID-MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 W LAKE LANSING RD STE 200
EAST LANSING MI
48823-6322
US

IV. Provider business mailing address

808 W LAKE LANSING RD STE 200
EAST LANSING MI
48823-6322
US

V. Phone/Fax

Practice location:
  • Phone: 517-618-9515
  • Fax:
Mailing address:
  • Phone: 517-618-9515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JULIE ROY
Title or Position: OWNER/LMSW
Credential:
Phone: 517-618-9515