Provider Demographics
NPI:1225461411
Name:COMBS, JOHN MITCHELL (LLPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MITCHELL
Last Name:COMBS
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 ANN ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-1261
Mailing Address - Country:US
Mailing Address - Phone:517-525-4648
Mailing Address - Fax:
Practice Address - Street 1:602 ANN ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1261
Practice Address - Country:US
Practice Address - Phone:517-525-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013712101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor