MEDICARE: MS. JETTE ENGELUND FRIIS LPC, NCC, CRC

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
1	101YP2500X	Professional Counselor	6401007567	MI
2	101YS0200X	School Counselor	027405	MI

General Provider Information

NPI Number	:	1851593032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JETTE ENGELUND FRIIS LPC, NCC, CRC

Provider Business Mailing Address
First Line	:	526 W 14 MILE RD
Second Line	:	UNIT B
City	:	CLAWSON
State	:	MI
Zip	:	48017-3103
Country	:	US
Telephone Number	:	248-655-0056
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 WOODWARD HTS
Second Line	:
City	:	FERNDALE
State	:	MI
Zip	:	48220-3007
Country	:	US
Telephone Number	:	248-543-4138
Fax Number	:	248-543-4253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	09/11/2025

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