Provider Demographics
NPI:1427408756
Name:BOIVIN, JAMIE (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:BOIVIN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:KREMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC
Mailing Address - Street 1:G3169 BEECHER ROAD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532
Mailing Address - Country:US
Mailing Address - Phone:517-676-5405
Mailing Address - Fax:
Practice Address - Street 1:G3169 BEECHER ROAD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:517-676-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI6451022352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other