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General NPI Number Information
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NPI Number | 1073445235
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Entity Type | Organization
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Legal Business Name | GREAT LAKES ONLINE COUNSELING LLC
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 602 BLOOMFIELD RD
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2835
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Country | US
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Telephone | 231-735-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 602 BLOOMFIELD RD STE 300
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2835
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Country | US
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Telephone | 231-590-9852
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. JOSEPH SANOK
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Credential | MA, LPC
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Telephone | 231-590-9852
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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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Taxonomy #2
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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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