Healthcare Provider Details

I. General information

NPI: 1568920494
Provider Name (Legal Business Name): INSTAR HEALING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 W LAKE LANSING RD STE 700
EAST LANSING MI
48823-8482
US

IV. Provider business mailing address

1130 LINCOLN AVE
LANSING MI
48910-3517
US

V. Phone/Fax

Practice location:
  • Phone: 517-614-1956
  • Fax:
Mailing address:
  • Phone: 517-614-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JAZMIN WILLIAMS
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LMSW
Phone: 517-614-3723