Provider Demographics
NPI:1972136430
Name:JANKELOVITZ, ABIGAIL ORBUCH (LLPC, NCC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ORBUCH
Last Name:JANKELOVITZ
Suffix:
Gender:F
Credentials:LLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4996 TRAIL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4563
Mailing Address - Country:US
Mailing Address - Phone:248-737-9011
Mailing Address - Fax:
Practice Address - Street 1:4996 TRAIL RIDGE CT
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4563
Practice Address - Country:US
Practice Address - Phone:248-737-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018133101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health