Healthcare Provider Details

I. General information

NPI: 1174455158
Provider Name (Legal Business Name): RADIANT LIFE COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PARKLANE BLVD STE 122
DEARBORN MI
48126-4206
US

IV. Provider business mailing address

6 PARKLANE BLVD STE 122
DEARBORN MI
48126-4206
US

V. Phone/Fax

Practice location:
  • Phone: 313-649-7382
  • Fax:
Mailing address:
  • Phone: 313-649-7382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MARSCHEIDER
Title or Position: PRACTICE OWNER, HEAD CLINICIAN
Credential: LPC, LLP, CCTP
Phone: 313-649-7382