Healthcare Provider Details

I. General information

NPI: 1427408756
Provider Name (Legal Business Name): JAMIE BOIVIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE KREMER LLPC

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 N SHIAWASSEE ST
OWOSSO MI
48867-2232
US

IV. Provider business mailing address

525 OKEMOS ST
MASON MI
48854-1226
US

V. Phone/Fax

Practice location:
  • Phone: 989-723-0330
  • Fax:
Mailing address:
  • Phone: 517-833-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451022352
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: