Healthcare Provider Details

I. General information

NPI: 1053233403
Provider Name (Legal Business Name): CHRISTIE BROOKE CAVER LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8949 DIXIE HWY
CLARKSTON MI
48348-4246
US

IV. Provider business mailing address

8949 DIXIE HWY
CLARKSTON MI
48348-4246
US

V. Phone/Fax

Practice location:
  • Phone: 810-626-5191
  • Fax: 906-451-5646
Mailing address:
  • Phone: 810-626-5191
  • Fax: 906-451-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6851121466
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: