Doctor Name: | LYLE L. LABARDEE |
NPI Number: | 1043537574 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 6401003943 |
Business Practice Address: | 2411 Byron Station Dr., Sw Suite 3 Byron Center, MI - 493158412 |
Business Phone Number: | 6167246943 |
Business Fax Number: | |
Mailing Address: | 2411 Byron Station Dr., Sw, Suite 3 BYRON CENTER |
State: | MI |
Postal Code: | 493158412 |
Phone Number: | 6167246943 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2010 |
NPI Last Update Date: | 08/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401003943 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |