Healthcare Provider Details

I. General information

NPI: 1689229528
Provider Name (Legal Business Name): JUBILEE XINIAN COUNSELING AND CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 E MOUNT HOPE AVE STE 2
LANSING MI
48910-1931
US

IV. Provider business mailing address

942 CRESENWOOD RD
EAST LANSING MI
48823-4118
US

V. Phone/Fax

Practice location:
  • Phone: 517-245-0725
  • Fax:
Mailing address:
  • Phone: 517-245-0725
  • 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: XINYI FANG
Title or Position: OWNER
Credential: MA, LPC
Phone: 517-245-0725