Provider Demographics
NPI:1134868763
Name:POZIWILKO, LINDSAY PORRITT PEIRCE (LPC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:PORRITT PEIRCE
Last Name:POZIWILKO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:PORRITT
Other - Last Name:PEIRCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:300 68TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-6927
Mailing Address - Country:US
Mailing Address - Phone:616-455-5000
Mailing Address - Fax:616-281-6459
Practice Address - Street 1:300 68TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49548-6927
Practice Address - Country:US
Practice Address - Phone:616-559-5896
Practice Address - Fax:616-281-6459
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222383101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional