Healthcare Provider Details

I. General information

NPI: 1578304580
Provider Name (Legal Business Name): MICHIGAN MENTAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 PARK ST
PLAINWELL MI
49080-1655
US

IV. Provider business mailing address

1634 LINCOLN RD
ALLEGAN MI
49010-9410
US

V. Phone/Fax

Practice location:
  • Phone: 269-224-2773
  • Fax: 269-224-2793
Mailing address:
  • Phone: 269-870-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. KEVIN JAMES LOUNSBERRY JR.
Title or Position: OWNER
Credential: LPC
Phone: 269-870-4780