Basic Information
| Provider Information | |||||||||
| NPI: | 1760804140 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANNI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | CHRISTY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA, LLPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 427 E KENILWORTH AVE | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480673745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862919704 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 40522 HAYES RD STE 600 | ||||||||
| Address2: | |||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480385904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862602404 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2014 | ||||||||
| LastUpdateDate: | 01/20/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401013072 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YS0200X | PF0000000779738 | MI | N | Behavioral Health & Social Service Providers | Counselor | School |
No ID Information.