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NPI Code Detail

MEDICARE: AMY FRESCH LPC

MEDICARE: AMY FRESCH 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 Counselor6401019393MI

General Provider Information

NPI Number : 1619544921
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY FRESCH LPC
Provider Business Mailing Address
First Line : 550 STEPHENSON HWY STE 200
Second Line :
City : TROY
State : MI
Zip : 48083-1132
Country : US
Telephone Number : 248-765-0884
Fax Number : 248-616-9759
Provider Business Practice Location Address
First Line : 550 STEPHENSON HWY STE 200
Second Line :
City : TROY
State : MI
Zip : 48083-1132
Country : US
Telephone Number : 248-765-0884
Fax Number : 248-616-9759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2021
Last Update Date : 02/28/2024

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