Provider Demographics
NPI:1174826812
Name:METZ, CAROLYNN MEREDITH (LPC, CAADC, CCS-R)
Entity type:Individual
Prefix:
First Name:CAROLYNN
Middle Name:MEREDITH
Last Name:METZ
Suffix:
Gender:F
Credentials:LPC, CAADC, CCS-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28325 ROCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3639
Mailing Address - Country:US
Mailing Address - Phone:586-854-4657
Mailing Address - Fax:
Practice Address - Street 1:20651 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2698
Practice Address - Country:US
Practice Address - Phone:313-271-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional