Healthcare Provider Details

I. General information

NPI: 1902077688
Provider Name (Legal Business Name): LISBETH L.A. BYERLEY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 06/11/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6004 VIENNA WAY
LANSING MI
48917-5005
US

IV. Provider business mailing address

6004 VIENNA WAY
LANSING MI
48917-5005
US

V. Phone/Fax

Practice location:
  • Phone: 517-281-0641
  • Fax:
Mailing address:
  • Phone: 517-646-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401005588
License Number StateMI

VIII. Authorized Official

Name: LISBETH L.A. BYERLEY
Title or Position: OWNER
Credential: M.A., LPC
Phone: 517-281-0641