Healthcare Provider Details

I. General information

NPI: 1760733802
Provider Name (Legal Business Name): HYGEIA CENTER FOR HEALING ARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N 5TH AVE
ANN ARBOR MI
48104-1195
US

IV. Provider business mailing address

220 N 5TH AVE
ANN ARBOR MI
48104-1195
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-6100
  • Fax: 734-761-8106
Mailing address:
  • Phone: 734-769-6100
  • Fax: 734-761-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6301015341
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301014066
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801064782
License Number StateMI

VIII. Authorized Official

Name: MS. SIERRA HILLEBRAND
Title or Position: MENTAL HEALTH PROGRAM DIRECTOR
Credential: M.A.
Phone: 734-769-6100