Healthcare Provider Details
I. General information
NPI: 1336377225
Provider Name (Legal Business Name): MARCI RENE-NELSON CYPHERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2009
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4295 OKEMOS RD STE 135
OKEMOS MI
48864-6201
US
IV. Provider business mailing address
3960 PATIENT CARE WAY STE 104
LANSING MI
48911-4276
US
V. Phone/Fax
- Phone: 517-306-4635
- Fax: 517-244-8707
- Phone: 517-887-9801
- Fax: 517-887-9826
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401011180 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: