Provider Demographics
NPI:1982254868
Name:AON, AUTUMN JOELLE (MA, LLPC)
Entity Type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:JOELLE
Last Name:AON
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:JOELLE
Other - Last Name:KNEEFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4964 CRABAPPLE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-4016
Mailing Address - Country:US
Mailing Address - Phone:734-812-9580
Mailing Address - Fax:
Practice Address - Street 1:5745 W MAPLE RD STE 202
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4489
Practice Address - Country:US
Practice Address - Phone:248-862-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015262101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor