Basic Information
| Provider Information | |||||||||
| NPI: | 1407506553 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WANDER MORE COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2535 E MOUNT HOPE AVE | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489101913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346266113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2535 E MOUNT HOPE AVE | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489101913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346266113 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2022 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | SAJDAK | ||||||||
| AuthorizedOfficialFirstName: | KELLE | ||||||||
| AuthorizedOfficialMiddleName: | KATHLEEN | ||||||||
| AuthorizedOfficialTitleorPosition: | COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 7346266113 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.