Healthcare Provider Details

I. General information

NPI: 1720024672
Provider Name (Legal Business Name): SHEPHERDS STAFF COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 DOBIE RD STE 270
OKEMOS MI
48864-6909
US

IV. Provider business mailing address

4655 DOBIE RD STE 270
OKEMOS MI
48864-6909
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-6700
  • Fax: 517-381-5362
Mailing address:
  • Phone: 517-333-6700
  • Fax: 517-381-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301008781
License Number StateMI

VIII. Authorized Official

Name: DR. CAROLYN SUE LUCAS
Title or Position: PSYCHOLOGIST, OWNER
Credential: PH.D.
Phone: 517-333-6700