Provider Demographics
NPI:1629222039
Name:STELLINI, DIANE LOIS (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LOIS
Last Name:STELLINI
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7192 PINE KNOB RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4824
Mailing Address - Country:US
Mailing Address - Phone:248-534-0866
Mailing Address - Fax:
Practice Address - Street 1:6770 DIXIE HWY.
Practice Address - Street 2:STE. 312
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-922-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010319101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor