Healthcare Provider Details

I. General information

NPI: 1750931630
Provider Name (Legal Business Name): UNCOMPLICATED COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 CENTURION DR STE 200
LANSING MI
48917-8273
US

IV. Provider business mailing address

6639 CENTURION DR STE 200
LANSING MI
48917-8273
US

V. Phone/Fax

Practice location:
  • Phone: 231-201-6565
  • Fax:
Mailing address:
  • Phone: 231-201-6565
  • 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: JOHN CHRISTOPHER SULLIVAN
Title or Position: OWNER/COUNSELOR
Credential: LLPC
Phone: 757-553-4280