Healthcare Provider Details

I. General information

NPI: 1467319277
Provider Name (Legal Business Name): HALO THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W GRAND RIVER AVE # 854
BRIGHTON MI
48116-2303
US

IV. Provider business mailing address

3345 S LATSON RD
HOWELL MI
48843-8815
US

V. Phone/Fax

Practice location:
  • Phone: 248-798-3885
  • Fax:
Mailing address:
  • Phone: 248-798-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA L TLUCZEK-JESSEE
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LMSC-C
Phone: 248-798-3885