Healthcare Provider Details

I. General information

NPI: 1447173125
Provider Name (Legal Business Name): AMANDA FAITH RESSLER LLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5980 S MAIN ST STE 101
CLARKSTON MI
48346-2377
US

IV. Provider business mailing address

5980 S MAIN ST STE 101
CLARKSTON MI
48346-2377
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-0920
  • Fax: 248-625-6829
Mailing address:
  • Phone: 248-266-0920
  • Fax: 248-625-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025064
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: