Healthcare Provider Details

I. General information

NPI: 1316603590
Provider Name (Legal Business Name): INTERNAL HEALING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 ROSETTA ST
DEARBORN HEIGHTS MI
48127-2345
US

IV. Provider business mailing address

835 MASON ST # B312
DEARBORN MI
48124-2231
US

V. Phone/Fax

Practice location:
  • Phone: 248-788-6873
  • Fax:
Mailing address:
  • Phone: 248-788-6873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MALAK BERRO
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 248-788-6873