Provider Demographics
NPI:1225467129
Name:LEFTWICH, JOSEPHINE (MA,LLP, LPC)
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:
Last Name:LEFTWICH
Suffix:
Gender:F
Credentials:MA,LLP, LPC
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31201 CHICAGO RD S STE A201
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-5552
Mailing Address - Country:US
Mailing Address - Phone:248-543-0033
Mailing Address - Fax:248-548-5309
Practice Address - Street 1:31201 CHICAGO RD S STE A201
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5552
Practice Address - Country:US
Practice Address - Phone:248-543-0033
Practice Address - Fax:248-548-5309
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015627103T00000X
MI6401013851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist