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NPI Code Detail

MEDICARE: SOUZAN VANLERBERG

MEDICARE: SOUZAN VANLERBERG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6451022875MI

General Provider Information

NPI Number : 1265288914
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOUZAN VANLERBERG
Provider Business Mailing Address
First Line : 43532 POND VIEW DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48314-1822
Country : US
Telephone Number : 818-633-2223
Fax Number :
Provider Business Practice Location Address
First Line : 3601 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5356
Country : US
Telephone Number : 586-722-7253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2024
Last Update Date : 04/24/2024

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Directions to “ SOUZAN VANLERBERG ” Practice Location

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