Provider Demographics
NPI:1861867483
Name:EARLY, MICHAEL JOHN (MA, LLPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:EARLY
Suffix:
Gender:M
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26105 ORCHARD LAKE RD STE 309
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4510
Mailing Address - Country:US
Mailing Address - Phone:248-957-9163
Mailing Address - Fax:248-957-9165
Practice Address - Street 1:26105 ORCHARD LAKE RD STE 309
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4510
Practice Address - Country:US
Practice Address - Phone:248-957-9163
Practice Address - Fax:248-957-9165
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401013845101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional