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NPI Code Detail

MEDICARE: SHONDRA A MOTLOCH LPC

MEDICARE: SHONDRA A MOTLOCH LPC
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 Counselor6401005652MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16401005652OTHERMIAPPLY FOR NPI
26401005652OTHERMIMENTAL HEALTH

General Provider Information

NPI Number : 1477269918
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHONDRA A MOTLOCH LPC
Provider Business Mailing Address
First Line : 38538 APPLEWOOD ST
Second Line :
City : CLINTON TWP
State : MI
Zip : 48036-1808
Country : US
Telephone Number : 586-873-3651
Fax Number :
Provider Business Practice Location Address
First Line : 38538 APPLEWOOD ST
Second Line :
City : CLINTON TWP
State : MI
Zip : 48036-1808
Country : US
Telephone Number : 586-873-3651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2023
Last Update Date : 01/27/2023

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Directions to “ SHONDRA A MOTLOCH LPC” Practice Location

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