Provider Demographics
NPI:1093901589
Name:MALSEED, JOANNE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MALSEED
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52188 VAN DYKE AVE STE 319
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3571
Mailing Address - Country:US
Mailing Address - Phone:586-262-9503
Mailing Address - Fax:
Practice Address - Street 1:52188 VAN DYKE AVE STE 319
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3571
Practice Address - Country:US
Practice Address - Phone:586-262-9503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008492101Y00000X
MI6401009856101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)