Provider Demographics
NPI:1508420811
Name:HEATHER LAFOLLETTE, MS, MA, LPC, LLC
Entity Type:Organization
Organization Name:HEATHER LAFOLLETTE, MS, MA, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAFOLLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MA, LPC
Authorized Official - Phone:517-449-4284
Mailing Address - Street 1:29658 WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4092
Mailing Address - Country:US
Mailing Address - Phone:517-449-4284
Mailing Address - Fax:
Practice Address - Street 1:650 E BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1432
Practice Address - Country:US
Practice Address - Phone:517-449-4284
Practice Address - Fax:248-817-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty