Provider Demographics
NPI:1669354601
Name:LJ4 COUNSELING AND CONSULTING SERVICES
Entity type:Organization
Organization Name:LJ4 COUNSELING AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAKISHA
Authorized Official - Middle Name:VETERNA
Authorized Official - Last Name:LASHORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMSW
Authorized Official - Phone:734-386-6501
Mailing Address - Street 1:42517 LILLEY POINTE DR # 7
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3854
Mailing Address - Country:US
Mailing Address - Phone:734-386-6501
Mailing Address - Fax:
Practice Address - Street 1:42517 LILLEY POINTE DR # 7
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3854
Practice Address - Country:US
Practice Address - Phone:734-386-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty