Keith Allen, MA, LPC

Individual provider Active NPI Professional Counselor · Grand Blanc, MI

NPI 1922439918 · NPPES record last updated Dec 2, 2013

Key facts

NPI
1922439918
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6401009089 (MI)
Practice address
9164 Del Rio Dr
Grand Blanc, MI 48439-8016
Phone
(810) 232-9950
Fax
(810) 232-7599
NPI assigned
Dec 2, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401009089MIMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401009089 MI Yes

Addresses

Primary practice location

9164 Del Rio Dr
Grand Blanc, MI 48439-8016

Mailing address

9164 Del Rio Dr
Grand Blanc, MI 48439-8016
Phone (810) 232-9950

Other providers in Grand Blanc, MI

All providers in Grand Blanc, MI · Professional Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.