=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619433521
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INSIGHT COUNSELING SERVICES OF GREATER LANSING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2019
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 311 HARRISON ST
-----------------------------------------------------
City | GRAND LEDGE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48837-1577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-338-3090
-----------------------------------------------------
Fax | 571-338-3090
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 HARRISON ST
-----------------------------------------------------
City | GRAND LEDGE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48837-1577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-338-3090
-----------------------------------------------------
Fax | 517-338-3090
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JULIANNA R SHALTRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 517-338-3090
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------