Provider Demographics
NPI:1710433214
Name:FINKELSTEIN, JACOB (LPC)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:FINKELSTEIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:YAKOV
Other - Middle Name:
Other - Last Name:FINKELSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5531 FOX HUNT LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15700 W 10 MILE RD STE 101A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2100
Practice Address - Country:US
Practice Address - Phone:443-927-6967
Practice Address - Fax:248-876-3691
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional