Provider Demographics
NPI:1376086363
Name:MI AWARENESS PLLC
Entity Type:Organization
Organization Name:MI AWARENESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:RAWLINS
Authorized Official - Suffix:III
Authorized Official - Credentials:LPC
Authorized Official - Phone:844-642-9273
Mailing Address - Street 1:189 W CLARKSTON RD
Mailing Address - Street 2:#18
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2892
Mailing Address - Country:US
Mailing Address - Phone:844-642-9273
Mailing Address - Fax:810-452-6007
Practice Address - Street 1:189 W CLARKSTON RD
Practice Address - Street 2:#18
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2892
Practice Address - Country:US
Practice Address - Phone:844-642-9273
Practice Address - Fax:810-452-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012158101YP2500X
MI6801098637104100000X
MI68010943181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty