Provider Demographics
NPI:1750078390
Name:SILVER LAKE COUNSELING
Entity type:Organization
Organization Name:SILVER LAKE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-428-7909
Mailing Address - Street 1:15173 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-1381
Mailing Address - Country:US
Mailing Address - Phone:810-428-7909
Mailing Address - Fax:
Practice Address - Street 1:15173 NORTH RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1381
Practice Address - Country:US
Practice Address - Phone:810-428-7909
Practice Address - Fax:810-519-8063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty