Individual
MARK CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
14165 N FENTON RD STE 102A2, FENTON, MI 48430-1186
(810) 282-4093
Mailing address
14165 N FENTON RD STE 102A2, FENTON, MI 48430-1186
(810) 282-4093
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401011415
MI
101YP2500X
Professional Counselor
Primary
6401011415
MI
Other
Enumeration date
10/20/2015
Last updated
06/24/2022
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