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General NPI Number Information
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NPI Number | 1588581516
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Entity Type | Organization
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Legal Business Name | LAKESIDE THERAPY GROUP
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 16201 PINE LAKE FOREST DR
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City | LINDEN
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State | MI
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Zip | 48451-9092
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Country | US
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Telephone | 810-813-1477
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Fax |
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Provider Business Mailing Address
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Address Line | 16201 PINE LAKE FOREST DR
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City | LINDEN
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State | MI
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Zip | 48451-9092
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Country | US
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Telephone | 810-813-1477
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/PSYCHOTHERAPIST
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Name | ASHLEY ZIOLKOWSKI
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Credential | LMSW
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Telephone | 586-383-1055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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