Provider Demographics
NPI:1811546112
Name:INTRASPECTIVES COUNSELING SERVICES
Entity Type:Organization
Organization Name:INTRASPECTIVES COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-708-8651
Mailing Address - Street 1:2966 QUARTZ DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3958
Mailing Address - Country:US
Mailing Address - Phone:248-709-8651
Mailing Address - Fax:
Practice Address - Street 1:2820 W MAPLE RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7064
Practice Address - Country:US
Practice Address - Phone:248-709-8651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty