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NPI Code Detail

MEDICARE: MS. SUSAN F CLEMENT LPC, NCC

MEDICARE: MS. SUSAN F CLEMENT LPC, NCC
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
1101YP2500XProfessional Counselor6401007787MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10998088OTHERMIHEALTH PLUS
2750910711OTHERMIBCBSM
31003325OTHERMIMCLAREN HEALTH PLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
51003325OTHERMIMCLAREN HEALTH ADVANTAGE

General Provider Information

NPI Number : 1588762561
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN F CLEMENT LPC, NCC
Provider Business Mailing Address
First Line : 3318 W SUTTON RD
Second Line :
City : LAPEER
State : MI
Zip : 48446-9812
Country : US
Telephone Number : 810-667-0500
Fax Number :
Provider Business Practice Location Address
First Line : 1570 SUNCREST DR
Second Line :
City : LAPEER
State : MI
Zip : 48446-1154
Country : US
Telephone Number : 810-667-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 01/29/2015

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