Organization
MICHIANA COUNSELING GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA L. LALA LCSW (LICENSED CLINICAL SOCIAL WORKER)
(574) 344-7941
Entity
Organization
Contact information
Practice address
56218 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9326
(574) 293-0005
(574) 293-0019
Mailing address
56218 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9326
(574) 293-0005
(574) 293-0019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003589A
IN
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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