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General NPI Number Information
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NPI Number | 1013846401
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Entity Type | Organization
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Legal Business Name | LAKESHORE GUIDANCE LLC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 8046 TEAKWOOD DR
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City | JENISON
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State | MI
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Zip | 49428-7766
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Country | US
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Telephone | 616-826-3115
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Fax |
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Provider Business Mailing Address
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Address Line | 8046 TEAKWOOD DR
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City | JENISON
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State | MI
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Zip | 49428-7766
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Country | US
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Telephone | 616-826-3115
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Fax |
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | MR. JOHN L TUTTLE
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Credential | MA MED LPC
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Telephone | 616-826-3115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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