Provider Demographics
NPI:1639547961
Name:JOHNS, LINDSEY (LLPC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2121
Mailing Address - Country:US
Mailing Address - Phone:517-787-7920
Mailing Address - Fax:517-787-2440
Practice Address - Street 1:300 W LOUIS GLICK HWY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1228
Practice Address - Country:US
Practice Address - Phone:517-782-9905
Practice Address - Fax:517-796-7022
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional