Blue Water Mental Health Clinic

NPI #1578601522 in Lexington, Michigan

Provider Information

NPI Number: 1578601522
Entity Type: Organization
Organization Name: Blue Water Mental Health Clinic
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Feb 2, 2007
Last Updated: Dec 28, 2010

Practice Location

Address: 5590 MAIN ST
Address 2: SUITE 3
City: Lexington
State: Michigan
ZIP Code: 48450-9386
Phone: (810) 985-5125

Authorized Official

Name: MRS. LINDA A. LIETHEN, LLP
Title: EXECUTIVE DIRECTOR
Phone: (810) 985-5125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X
Marriage & Family Therapist	106H00000X
Psychologist - Clinical — Clinical	103TC0700X
Social Worker - Clinical — Clinical	1041C0700X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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