Provider Demographics
NPI:1366075723
Name:CAPACITY COUNSELING, PLLC
Entity type:Organization
Organization Name:CAPACITY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-329-3099
Mailing Address - Street 1:42705 GRAND RIVER AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1772
Mailing Address - Country:US
Mailing Address - Phone:248-329-3099
Mailing Address - Fax:
Practice Address - Street 1:42705 GRAND RIVER AVE STE 201
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1772
Practice Address - Country:US
Practice Address - Phone:248-417-0229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health