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General NPI Number Information
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NPI Number | 1700388634
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Entity Type | Individual
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Provider Name | MARY BRIGETTE SITARSKI LPC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 229 E MICHIGAN AVE STE 345
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City | KALAMAZOO
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State | MI
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Zip | 49007-6403
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Country | US
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Telephone | 269-993-4373
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Fax | 269-544-7721
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone | 517-676-9788
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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 | 6401018313
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License Number State | MI
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