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Organization
MOSAIC COUNSELING
Active
Organization
MOSAIC COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LUCAS LPC (OWNER)
(248) 431-0475
Entity
Organization
Contact information
Practice address
4545 CLAWSON TANK DR, CLARKSTON, MI 48346-2581
(248) 431-0475
Mailing address
4545 CLAWSON TANK DR, CLARKSTON, MI 48346-2581
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H73582
BLUE CROSS PIN
—
Enumeration date
07/12/2019
Last updated
07/12/2019
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