| 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 |