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General NPI Number Information
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NPI Number | 1063156792
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Entity Type | Organization
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Legal Business Name | MY MICHIGAN LPC LLC
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 300 N 5TH AVE STE 230
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City | ANN ARBOR
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State | MI
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Zip | 48104-5504
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Country | US
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Telephone | 231-420-0964
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Fax |
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Provider Business Mailing Address
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Address Line | 883 FAIRWAY TRAILS DR
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City | BRIGHTON
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State | MI
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Zip | 48116-1762
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Country | US
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Telephone | 231-420-0964
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY ANN COMPTON
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Credential | LPC
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Telephone | 231-420-0964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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