Basic Information
| Provider Information | |||||||||
| NPI: | 1972048023 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMETT-YOUNT | ||||||||
| FirstName: | TERESITA | ||||||||
| MiddleName: | INES | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6549 TOWN CENTER DR STE A | ||||||||
| Address2: | |||||||||
| City: | CLARKSTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483464824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486206400 | ||||||||
| FaxNumber: | 2486206405 | ||||||||
| Practice Location | |||||||||
| Address1: | 2401 S LINDEN RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485329800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109574310 | ||||||||
| FaxNumber: | 8109574309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2016 | ||||||||
| LastUpdateDate: | 06/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401015843 | MI | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 6401017365 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.