Organization
GREAT LAKES CLINICAL GROUP, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SNIPES (OWNER)
(213) 827-3038
Entity
Organization
Contact information
Practice address
2709 PONTIAC LAKE RD FL 1, WATERFORD, MI 48328-2653
(313) 758-6857
Mailing address
2709 PONTIAC LAKE RD FL 1, WATERFORD, MI 48328-2653
(313) 758-6857
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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