Provider Demographics
NPI:1780264648
Name:HEALERS OF COLOR COLLABORATIVE OF MICHIGAN
Entity type:Organization
Organization Name:HEALERS OF COLOR COLLABORATIVE OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF EXTERNAL AFFAIRS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COBBON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-945-6497
Mailing Address - Street 1:P.O. BOX 26162
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909
Mailing Address - Country:US
Mailing Address - Phone:517-219-5761
Mailing Address - Fax:
Practice Address - Street 1:411 W LAKE LANSING RD
Practice Address - Street 2:SUITE C-120
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-219-5261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty