Provider Demographics
NPI:1427580695
Name:NANCY WARKENTIN HOUDEK, LPC, NCC, PLLC
Entity Type:Organization
Organization Name:NANCY WARKENTIN HOUDEK, LPC, NCC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARKENTIN HOUDEK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:586-215-8992
Mailing Address - Street 1:31300 NORTHWESTERN HWY STE B
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-5407
Mailing Address - Country:US
Mailing Address - Phone:586-215-8992
Mailing Address - Fax:
Practice Address - Street 1:31300 NORTHWESTERN HWY STE B
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5407
Practice Address - Country:US
Practice Address - Phone:586-215-8992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013893261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health