Provider Demographics
NPI:1225242431
Name:DOUCETTE, AMIRA (LPC, LLP)
Entity Type:Individual
Prefix:MS
First Name:AMIRA
Middle Name:
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:LPC, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 ALDEN DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2003
Mailing Address - Country:US
Mailing Address - Phone:248-933-9329
Mailing Address - Fax:248-624-7901
Practice Address - Street 1:6421 ALDEN DR
Practice Address - Street 2:
Practice Address - City:ORCHARD LAKE
Practice Address - State:MI
Practice Address - Zip Code:48324-2003
Practice Address - Country:US
Practice Address - Phone:248-933-9329
Practice Address - Fax:248-624-7901
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011404103T00000X
MI6401007666101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP108916200OtherBLUE CROSS BLUE SHIELD