Healthcare Provider Details

I. General information

NPI: 1497569719
Provider Name (Legal Business Name): PAULA STOTT LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W LENAWEE ST
LANSING MI
48933-2120
US

IV. Provider business mailing address

5510 CLARK RD
BATH MI
48808-8729
US

V. Phone/Fax

Practice location:
  • Phone: 517-712-6039
  • Fax:
Mailing address:
  • Phone: 517-712-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024082
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: