NPI | 1720423262 |
---|---|
Doing Business As | GREAT LAKES COUNSELING |
Entity Type | Organization |
Authorized Contact | PAUL LUCKI SMITH President 248-656-8500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TC0700X Psychologist, Clinical | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2013-05-09 |
Last Update Date | 2013-10-15 |