Healthcare Provider Details

I. General information

NPI: 1083331664
Provider Name (Legal Business Name): TRANSCENDING TRAUMA INSTITUTE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/22/2023
Certification Date: 10/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40315 MICHIGAN AVE # 1234
CANTON MI
48188-2908
US

IV. Provider business mailing address

40315 MICHIGAN AVE # 1234
CANTON MI
48188-2908
US

V. Phone/Fax

Practice location:
  • Phone: 734-353-1463
  • Fax: 734-293-0264
Mailing address:
  • Phone: 734-353-1463
  • Fax: 734-293-0264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA LAPIERA SUDDERTH
Title or Position: OWNER/CEO/CLINICAL PSYCHOTHERAPIST
Credential: MSW, LMSW
Phone: 734-353-1463