MEDICARE: LINDA BARBARA SPAINE 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
1	101YP2500X	Professional Counselor	6401017319	MI

General Provider Information

NPI Number	:	1881203651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA BARBARA SPAINE LPC

Provider Business Mailing Address
First Line	:	6199 MILLER RD STE A
Second Line	:
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1585
Country	:	US
Telephone Number	:	248-470-5791
Fax Number	:

Provider Business Practice Location Address
First Line	:	6199 MILLER RD STE A
Second Line	:
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1585
Country	:	US
Telephone Number	:	810-207-5759
Fax Number	:

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

Provider Enumeration Date	:	07/28/2020
Last Update Date	:	08/09/2021

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Directions to “ LINDA BARBARA SPAINE LPC” Practice Location

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