Healthcare Provider Details

I. General information

NPI: 1912625872
Provider Name (Legal Business Name): THERAPY, IT'S PERSONAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30472 23 MILE RD
CHESTERFIELD MI
48047-1844
US

IV. Provider business mailing address

71 WALNUT BLVD
ROCHESTER MI
48307-2073
US

V. Phone/Fax

Practice location:
  • Phone: 586-863-4000
  • Fax:
Mailing address:
  • Phone: 586-489-4424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NICOL GRISHKEVICH
Title or Position: OWNER / THERAPIST
Credential: MA, LPC, NCC
Phone: 586-330-0886