Provider Demographics
NPI:1932224136
Name:GLOBAL WELLNESS INC
Entity Type:Organization
Organization Name:GLOBAL WELLNESS INC
Other - Org Name:DR KAREN LACOURSE
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:LACOURSE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-414-7275
Mailing Address - Street 1:801 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067
Mailing Address - Country:US
Mailing Address - Phone:248-414-7275
Mailing Address - Fax:248-547-5285
Practice Address - Street 1:1112 CATALPA DR
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067
Practice Address - Country:US
Practice Address - Phone:248-414-7275
Practice Address - Fax:248-547-5285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103TC0700X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty