Provider Demographics
NPI:1407595473
Name:SAM LEMMER COUNSELING AND ECOTHERAPY
Entity Type:Organization
Organization Name:SAM LEMMER COUNSELING AND ECOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-961-7609
Mailing Address - Street 1:19477 47TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49026-9787
Mailing Address - Country:US
Mailing Address - Phone:312-961-7609
Mailing Address - Fax:
Practice Address - Street 1:19477 47TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:MI
Practice Address - Zip Code:49026-9787
Practice Address - Country:US
Practice Address - Phone:312-961-7609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-29
Last Update Date:2022-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty