Healthcare Provider Details

I. General information

NPI: 1861975724
Provider Name (Legal Business Name): LORRAINE MARCIA MCKNIGHT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 PEARL ST STE 302
YPSILANTI MI
48197-2663
US

IV. Provider business mailing address

8981 BRISTOL CT
YPSILANTI MI
48198-3204
US

V. Phone/Fax

Practice location:
  • Phone: 734-413-7988
  • Fax:
Mailing address:
  • Phone: 734-657-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401007158
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: