Provider Demographics
NPI:1578304580
Name:MICHIGAN MENTAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:MICHIGAN MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LOUNSBERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:269-870-4780
Mailing Address - Street 1:1634 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9410
Mailing Address - Country:US
Mailing Address - Phone:269-870-4780
Mailing Address - Fax:
Practice Address - Street 1:319 PARK ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1655
Practice Address - Country:US
Practice Address - Phone:269-685-9401
Practice Address - Fax:269-685-9403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty