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General NPI Number Information
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NPI Number | 1992450126
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Entity Type | Organization
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Legal Business Name | INTEGRATED ANXIETY MANAGEMENT (IAM)
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 12899 W HERBISON RD
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City | EAGLE
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State | MI
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Zip | 48822-9648
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Country | US
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Telephone | 517-242-1762
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Fax | 517-247-2844
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Provider Business Mailing Address
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Address Line | 12899 W HERBISON RD
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City | EAGLE
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State | MI
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Zip | 48822-9648
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Country | US
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Telephone | 517-242-1762
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Fax | 517-247-2844
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN MARIE BECKMAN-MITCHELL
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Credential | MA, LPC
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Telephone | 517-242-1762
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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 | 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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