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Organization
LAKEVIEW FAMILY COUNSELING CENTER LLC
Active
Organization
LAKEVIEW FAMILY COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY JO WILSON MA,LPC (OWNER)
(517) 403-4950
Entity
Organization
Contact information
Practice address
765 MANITOU ROAD, MANITOU BEACH, MI 49253
(517) 403-4950
(517) 252-5135
Mailing address
765 MANITOU ROAD, MANITOU BEACH, MI 49253
(517) 403-4950
(517) 252-5135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401011390
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401011390
STATE LICENSE
MI
Enumeration date
08/15/2013
Last updated
08/15/2013
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