Provider Demographics
NPI:1861089328
Name:LAVALLEE, JOCELYN KATHERINE (LPC)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:KATHERINE
Last Name:LAVALLEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:KATHERINE
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31675 SHIAWASSEE RD # B9
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3272
Mailing Address - Country:US
Mailing Address - Phone:248-568-9461
Mailing Address - Fax:
Practice Address - Street 1:23023 ORCHARD LAKE RD STE G
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-3267
Practice Address - Country:US
Practice Address - Phone:248-238-8794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health