Healthcare Provider Details

I. General information

NPI: 1902733686
Provider Name (Legal Business Name): ALYSON BUNDY COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 BROWNS LAKE RD
JACKSON MI
49201-8332
US

IV. Provider business mailing address

7111 BROWNS LAKE RD
JACKSON MI
49201-8332
US

V. Phone/Fax

Practice location:
  • Phone: 517-745-3800
  • Fax:
Mailing address:
  • Phone: 517-745-3800
  • 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: ALYSON BUNDY
Title or Position: PROFESSIONAL COUNSELING, OWNDER
Credential: LPC
Phone: 517-745-3800