Provider Demographics
NPI:1982140604
Name:DOWLING, JOHN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DOWLING
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 W SAINT JOSEPH ST
Mailing Address - Street 2:SUITE A101
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-3666
Mailing Address - Country:US
Mailing Address - Phone:517-321-5900
Mailing Address - Fax:517-321-5945
Practice Address - Street 1:3815 W SAINT JOSEPH ST
Practice Address - Street 2:SUITE A101
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-3666
Practice Address - Country:US
Practice Address - Phone:517-321-5900
Practice Address - Fax:517-321-5945
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003899101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional