Organization
INDIGO NORTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PAYNE LPC (OWNER)
(810) 923-2483
Entity
Organization
Contact information
Practice address
383 STARKWEATHER ST STE 1, PLYMOUTH, MI 48170-1373
(734) 386-0238
Mailing address
42524 SARATOGA RD, CANTON, MI 48187-3011
(734) 386-0238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/06/2021
Last updated
02/15/2024
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