Healthcare Provider Details

I. General information

NPI: 1043122955
Provider Name (Legal Business Name): CALESTA HARRISON LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRIARWOOD CIR STE 400
ANN ARBOR MI
48108-1650
US

IV. Provider business mailing address

1601 BRIARWOOD CIR STE 400
ANN ARBOR MI
48108-1650
US

V. Phone/Fax

Practice location:
  • Phone: 734-822-4971
  • Fax:
Mailing address:
  • Phone: 734-822-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451025254
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: