Provider Demographics
NPI:1629473947
Name:FALEY, LORI (MA, LPC, QMHP, CAADC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:FALEY
Suffix:
Gender:F
Credentials:MA, LPC, QMHP, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4273 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858
Mailing Address - Country:US
Mailing Address - Phone:989-953-4357
Mailing Address - Fax:
Practice Address - Street 1:4273 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-953-4357
Practice Address - Fax:989-455-1112
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-03181101YA0400X
MI6401006142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)