NPIMap

Organization Active NPI

Lakeside Professional Counseling, P.C.

  • Mental Health Counselor
  • Shelby Township, MI
National Provider Identifier
1073084083
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LAKESIDE PROFESSIONAL COUNSELING, P.C.
Practice address
8072 21 Mile Rd
Shelby Township, MI 48317-4310
Phone
(586) 932-2700
Fax
(586) 932-2705
NPI assigned
Dec 17, 2018
Last updated
Jun 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica J Lentz, LPCNPI 1487194890
Title
President
Phone
(586) 932-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8072 21 Mile Rd
Shelby Township, MI 48317-4310

Mailing address

8072 21 Mile Rd
Shelby Township, MI 48317-4310
Phone (586) 932-2700

Other practice location 1

212 W Highland Rd Ste 102
Highland, MI 48357-4504
Phone (586) 932-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210824003131 MI Part B Supplier - Clinic/Group Practice 8729483078 Receives reassigned benefits from 15 practitioners
Practice locations: Highland, MI; Shelby TWP, MI

National Provider Directory

National Provider Directory

Locations

8072 21 Mile Rd
Shelby Township, MI 48317
Phone (586) 491-6909

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1073084083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8072 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174310",
            "telephone_number": "586-932-2700",
            "fax_number": "586-932-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8072 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174310",
            "telephone_number": "586-932-2700",
            "fax_number": "586-932-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 W Highland Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "MI",
            "postal_code": "483574504",
            "country_code": "US",
            "telephone_number": "586-932-2700",
            "fax_number": "586-932-2705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKESIDE PROFESSIONAL COUNSELING, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-932-2700",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.