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General NPI Number Information
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NPI Number | 1174064968
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Entity Type | Organization
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Legal Business Name | INTERPERSONAL GROWTH COUNSELING, PLLC.
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1031 S MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2022
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Country | US
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Telephone | 734-359-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 S MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2022
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Country | US
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Telephone | 734-359-5500
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. KELLY L LINDSAY
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Credential | OWNER, MA, LPC
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Telephone | 734-658-3050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | MI
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