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Individual

MRS. LAURIE SCHEID RUDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, NCC, CAAC

Contact information

Practice address
5985 W MAIN ST, SUITE 809, KALAMAZOO, MI 49009-8708
(269) 929-6964
Mailing address
5937 W MAIN ST, KALAMAZOO, MI 49009-9101
(269) 929-6964

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-00572
MI
101YP2500X
Professional Counselor
Primary
6401009641
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201686
INTERNATIONAL CERTIFICATION AND RECIPROCITY CONSORTIUM
MI
01
208703
NATIONAL BOARD FOR CERTIFIED COUNSELORS INC
MI
01
6401009641
PROF COUNSEL LL
MI
01
C-00572
MICHIGAN CERTIFICATION BOARD FOR ADDICTION PROFESSIONALS
MI
Enumeration date
02/10/2007
Last updated
09/18/2013
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