Healthcare Provider Details

I. General information

NPI: 1669776944
Provider Name (Legal Business Name): CYNTHIA E PAHLKOTTER BS, MA, LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2010
Last Update Date: 12/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 CLEO ST
LANSING MI
48915-1437
US

IV. Provider business mailing address

1019 CLEO ST
LANSING MI
48915-1437
US

V. Phone/Fax

Practice location:
  • Phone: 517-803-1302
  • Fax:
Mailing address:
  • Phone: 517-803-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401010768
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number227493
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: