Individual
LISA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
4062 NOTTINGHAM CIR, CLARKSTON, MI 48346-1760
(248) 804-9257
Mailing address
4062 NOTTINGHAM CIR, CLARKSTON, MI 48346-1760
(248) 804-9257
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451024747
MI
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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