Provider Demographics
NPI:1528545092
Name:CASE, AUBRIE (LLPC)
Entity type:Individual
Prefix:
First Name:AUBRIE
Middle Name:
Last Name:CASE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:AUBRIE
Other - Middle Name:
Other - Last Name:PHENIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC
Mailing Address - Street 1:115 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIMAX
Mailing Address - State:MI
Mailing Address - Zip Code:49034-9514
Mailing Address - Country:US
Mailing Address - Phone:269-626-6141
Mailing Address - Fax:
Practice Address - Street 1:6070 NEWPORT RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-9234
Practice Address - Country:US
Practice Address - Phone:269-409-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health