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General NPI Number Information
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NPI Number | 1194302786
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Entity Type | Organization
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Legal Business Name | THREE OAKS COUNSELING, LLC
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Dates
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Enumeration Date | 03/28/2021
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 808 W LAKE LANSING RD STE 200
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City | EAST LANSING
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State | MI
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Zip | 48823-6322
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Country | US
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Telephone | 517-575-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 522 E SHAW ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1955
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Country | US
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Telephone | 231-675-6184
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Fax |
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Authorized Official
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Title or Position | CREDENTIALER
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Name | MRS. FRANK NEWSOME
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Credential |
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Telephone | 517-442-3341
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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