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General NPI Number Information
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NPI Number | 1265789119
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Entity Type | Individual
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Provider Name | JEFFREY ALLEN CARION MA,LLPC
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Gender | Male
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 35455 GARFIELD RD SUITE C
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City | CLINTON TWP
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State | MI
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Zip | 48035-2236
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Country | US
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Telephone | 586-792-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 43663 SUNNYPOINT DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-2166
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Country | US
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Telephone | 586-247-6729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401012814
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License Number State | MI
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