Provider Demographics
NPI:1659762110
Name:COUNSELLOR, JAMES L (MA, LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:COUNSELLOR
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:844-832-1956
Mailing Address - Fax:989-633-5241
Practice Address - Street 1:211 LONG RAPIDS RD
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1315
Practice Address - Country:US
Practice Address - Phone:989-354-2142
Practice Address - Fax:989-354-8600
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401009538101YP2500X, 101YP2500X
MI7501005113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist