Healthcare Provider Details

I. General information

NPI: 1356517791
Provider Name (Legal Business Name): ALPHA FAMILY COUNSELING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43996 WOODWARD AVE SUITE 02
BLOOMFIELD HILLS MI
48302-5027
US

IV. Provider business mailing address

34556 BUNKER HILL DR
FARMINGTON HILLS MI
48331-3225
US

V. Phone/Fax

Practice location:
  • Phone: 248-579-0856
  • Fax: 248-489-1940
Mailing address:
  • Phone: 248-579-0856
  • Fax: 248-489-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID M JOSEPH
Title or Position: MANAGING DIRECTOR
Credential: MBA, LLMSW
Phone: 248-579-0856