Provider Demographics
NPI:1992178362
Name:GREGG E NATKOWSKI, PC
Entity Type:Organization
Organization Name:GREGG E NATKOWSKI, PC
Other - Org Name:LIVING LIFE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:E
Authorized Official - Last Name:NATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-923-5760
Mailing Address - Street 1:37677 PROFESSIONAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1192
Mailing Address - Country:US
Mailing Address - Phone:810-923-5760
Mailing Address - Fax:810-225-0980
Practice Address - Street 1:37677 PROFESSIONAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1192
Practice Address - Country:US
Practice Address - Phone:810-923-5760
Practice Address - Fax:810-225-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-07
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty