Provider Demographics
NPI:1497337851
Name:GENERATIONS COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:GENERATIONS COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAMPINATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-783-6203
Mailing Address - Street 1:3079 S BALDWIN RD STE 1099
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1028
Mailing Address - Country:US
Mailing Address - Phone:248-783-6203
Mailing Address - Fax:
Practice Address - Street 1:3079 S BALDWIN RD STE 1099
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-1028
Practice Address - Country:US
Practice Address - Phone:248-783-6203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center