Healthcare Provider Details

I. General information

NPI: 1841891363
Provider Name (Legal Business Name): ASHLEY CASALOU MA LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36400 WOODWARD AVE STE 20
BLOOMFIELD HILLS MI
48304-0914
US

IV. Provider business mailing address

36400 WOODWARD AVE STE 20
BLOOMFIELD HILLS MI
48304-0914
US

V. Phone/Fax

Practice location:
  • Phone: 313-744-2496
  • Fax:
Mailing address:
  • Phone: 313-744-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY CASALOU
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: MA LPC CCTP
Phone: 313-744-2496