Provider Demographics
NPI:1154758787
Name:UNAEZE, OBIOHA COLLINS (MA, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:OBIOHA
Middle Name:COLLINS
Last Name:UNAEZE
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 LOVERS LN STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-1579
Mailing Address - Country:US
Mailing Address - Phone:800-676-0423
Mailing Address - Fax:
Practice Address - Street 1:5250 LOVERS LN STE 200
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-1579
Practice Address - Country:US
Practice Address - Phone:800-676-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013193101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional