| NPI | 1588947345 |
|---|---|
| Doing Business As | GREAT LAKES COUNSELING |
| Entity Type | Organization |
| Authorized Contact | PAUL LUCKI SMITH President 248-656-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2013-10-15 |