Provider Demographics
NPI:1700474939
Name:L&D CLINICAL AND CONSULTATIVE SERVICES
Entity Type:Organization
Organization Name:L&D CLINICAL AND CONSULTATIVE SERVICES
Other - Org Name:L&D CLINICAL AND CONSULTATIVE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAJOIE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW
Authorized Official - Phone:734-218-5012
Mailing Address - Street 1:4007 CARPENTER RD
Mailing Address - Street 2:PO BOX 145
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E CROSS ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-3818
Practice Address - Country:US
Practice Address - Phone:734-218-5012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty