MEDICARE: OPEN HEARTS COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1629869979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN HEARTS COUNSELING LLC

Provider Business Mailing Address
First Line	:	44060 WOODWARD AVE STE 204
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5040
Country	:	US
Telephone Number	:	248-978-2104
Fax Number	:

Provider Business Practice Location Address
First Line	:	44060 WOODWARD AVE STE 204
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5040
Country	:	US
Telephone Number	:	248-978-2104
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS JAMIE PHILLIPS
Credential	:	LPC, NCC
Telephone Number	:	248-978-2104

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/22/2025

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Directions to “OPEN HEARTS COUNSELING LLC ” Practice Location

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