Organization
NORTHERN LAKES COMMUNITY MENTAL HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA LONGSTREET (CHIEF CLINICAL OFFICER)
(231) 922-4850
Entity
Organization
Contact information
Practice address
105 HALL ST, SUITE A, TRAVERSE CITY, MI 49684-2288
(231) 922-4850
(231) 935-3856
Mailing address
105 HALL ST, SUITE A, TRAVERSE CITY, MI 49684-2288
(231) 922-4850
(231) 935-3856
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0750910832
BCBSM OPC GRAYLING
MI
Enumeration date
11/06/2006
Last updated
08/07/2026
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