Healthcare Provider Details

I. General information

NPI: 1205778248
Provider Name (Legal Business Name): BONDS AND BRIDGES COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 COLLINS RD UNIT 22062
LANSING MI
48924-9998
US

IV. Provider business mailing address

4800 COLLINS RD UNIT 22062
LANSING MI
48924-9998
US

V. Phone/Fax

Practice location:
  • Phone: 517-295-0115
  • Fax:
Mailing address:
  • Phone: 517-295-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEJA YOUNG
Title or Position: SYSTEMIC THERAPIST
Credential: LMFT
Phone: 336-470-3617