Lakeview Family Counseling Center LLC
Organization Active NPI Mental Health Counselor · Manitou Beach, MI
NPI 1407289374 · NPPES record last updated Aug 15, 2013
Key facts
- NPI
- 1407289374
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 6401011390 (MI)
- Legal business name
- LAKEVIEW FAMILY COUNSELING CENTER LLC
- Practice address
- 765 Manitou Road
Manitou Beach, MI 49253 - Phone
- (517) 403-4950
- Fax
- (517) 252-5135
- NPI assigned
- Aug 15, 2013
- Organization subpart
- No
Authorized official
- Name
- Mrs. Shirley Jo Wilson, MA,LPC
- Title
- Owner
- Phone
- (517) 403-4950
Practitioners 1
-
Shirley Jo Wilson, LPC
National Provider Directory
Locations
765 Manitou Rd
Manitou Beach, MI 49253
Phone (517) 403-4950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 6401011390 | MI | Yes |
Addresses
Primary practice location
765 Manitou Road
Manitou Beach, MI 49253
Mailing address
765 Manitou Road
Manitou Beach, MI 49253
Phone (517) 403-4950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6401011390 | Other | MI | STATE LICENSE |
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All providers in Manitou Beach, MI · Mental Health Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.