Healthcare Provider Details

I. General information

NPI: 1417737818
Provider Name (Legal Business Name): ENKELEDA GROPCAJ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42815 GARFIELD RD STE 201
CLINTON TOWNSHIP MI
48038-1143
US

IV. Provider business mailing address

19775 YVONNE DR
MACOMB MI
48044-6316
US

V. Phone/Fax

Practice location:
  • Phone: 586-333-5328
  • Fax:
Mailing address:
  • Phone: 586-549-6027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401226191
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: