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General NPI Number Information
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NPI Number | 1417289299
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Entity Type | Organization
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Legal Business Name | NORTH LAPEER COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 5914 N LAPEER RD
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City | NORTH BRANCH
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State | MI
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Zip | 48461-9778
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Country | US
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Telephone | 810-793-4646
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Fax | 810-793-4660
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Provider Business Mailing Address
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Address Line | 5914 N LAPEER RD
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City | NORTH BRANCH
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State | MI
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Zip | 48461-9778
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Country | US
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Telephone | 810-793-4646
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Fax | 810-793-4660
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Authorized Official
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Title or Position | MANAGING PARTNER/THERAPIST
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Name | ANITA JOLLY
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Credential | LPC
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Telephone | 810-793-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801013350
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401001683
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401008841
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License Number State | MI
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