Healthcare Provider Details

I. General information

NPI: 1013576446
Provider Name (Legal Business Name): TERRENCE B FLINT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37878 JEFFERSON AVE
HARRISON TWP MI
48045-4000
US

IV. Provider business mailing address

37878 JEFFERSON AVE
HARRISON TWP MI
48045-4000
US

V. Phone/Fax

Practice location:
  • Phone: 734-778-4706
  • Fax:
Mailing address:
  • Phone: 734-778-4706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401018224
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401018224
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: