Provider Demographics
NPI:1285164541
Name:PAIVA, LINDSEY MICHELLE HURYN (LLPC)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:MICHELLE HURYN
Last Name:PAIVA
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MICHELLE
Other - Last Name:HURYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9819 INGRAM ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2868
Mailing Address - Country:US
Mailing Address - Phone:440-829-2709
Mailing Address - Fax:
Practice Address - Street 1:835 MASON ST STE B220
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-561-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional