Healthcare Provider Details

I. General information

NPI: 1639671449
Provider Name (Legal Business Name): RECOARSE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 04/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 S CREYTS RD STE B
LANSING MI
48917-8266
US

IV. Provider business mailing address

612 S CREYTS RD STE B
LANSING MI
48917-8266
US

V. Phone/Fax

Practice location:
  • Phone: 517-285-0527
  • Fax: 517-220-4694
Mailing address:
  • Phone: 517-285-0527
  • Fax: 517-220-4694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201000678
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401012447
License Number StateMI

VIII. Authorized Official

Name: DR. DEBRA J FARRELL
Title or Position: OWNER / PRESIDENT
Credential: PHD, LPC, CCMHC, NCC
Phone: 517-285-0527