| Libby Lake Counseling Llc | |
|
2410 Grape Rd Ste 1 Mishawaka IN 46545-3015 | |
| (574) 298-7733 | |
| Not Available |
| Full Name | Libby Lake Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2410 Grape Rd Ste 1, Mishawaka, Indiana |
| Authorized Official Name and Position | Elizabeth Lake (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5742987733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Libby Lake Counseling Llc 2410 Grape Rd Ste 1 Mishawaka IN 46545-3015 Ph: (574) 298-7733 | Libby Lake Counseling Llc 2410 Grape Rd Ste 1 Mishawaka IN 46545-3015 Ph: (574) 298-7733 |
| NPI Number | 1205659554 |
|---|---|
| Provider Enumeration Date | 11/05/2024 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205659554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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