Provider Demographics
NPI:1235722158
Name:SPRINGSTEEN, ANN MARIE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:SPRINGSTEEN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52731 GOODENOUGH RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:MI
Mailing Address - Zip Code:49067-9725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52731 GOODENOUGH RD
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:MI
Practice Address - Zip Code:49067-9725
Practice Address - Country:US
Practice Address - Phone:269-506-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010624101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor