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General NPI Number Information
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NPI Number | 1659910099
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Entity Type | Organization
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Legal Business Name | SYNERGETIC ORGANIZATIONAL CONSULTING LLC
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 28611 LATHRUP BLVD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2849
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Country | US
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Telephone | 248-574-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 28611 LATHRUP BLVD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2849
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Country | US
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Telephone | 248-574-4425
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Fax |
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Authorized Official
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Title or Position | LEAD CONSULTANT
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Name | DR. LISA Y THOMAS
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Credential | PHD
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Telephone | 248-574-4425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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