Healthcare Provider Details

I. General information

NPI: 1669906988
Provider Name (Legal Business Name): BARLOW PROFESSIONAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31800 NORTHWESTERN HWY STE 340
FARMINGTON HILLS MI
48334-1665
US

IV. Provider business mailing address

31800 NORTHWESTERN HWY STE 340
FARMINGTON HILLS MI
48334-1665
US

V. Phone/Fax

Practice location:
  • Phone: 248-438-8254
  • Fax: 734-207-5326
Mailing address:
  • Phone: 248-438-8254
  • Fax: 734-207-5326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011509
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301015842
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. LASONIA A BARLOW
Title or Position: LPC/LLP/OWNER
Credential: LPC / LLP
Phone: 248-438-8254