IndividualActive
Andra Modock, MA, LLPC, NCE
NPI 1205417896 · Professional Counselor · Westland, MI
Provider details
- NPI number
- 1205417896
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Credential
- MA, LLPC, NCE
- Sex
- Female
- Sole proprietor
- Yes
- License
- LPCC.0018266 (CO)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
7415 Harrison St
Westland, MI 48185-2629
Phone: (734) 578-6019
Approximate (ZIP-level) locationGet directions
Mailing address
7415 Harrison St
Westland, MI 48185-2629
Registry dates
- Enumerated
- 2021-04-15
- Last updated
- 2021-04-15
- Certified
- 2021-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.