Healthcare Provider Details

I. General information

NPI: 1346002581
Provider Name (Legal Business Name): DOVE'S HEART COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 W OUTER DRIVE SUITE LL04
DETROIT MI
48235-3461
US

IV. Provider business mailing address

PO BOX 972844
YPSILANTI MI
48197-0323
US

V. Phone/Fax

Practice location:
  • Phone: 734-255-4000
  • Fax: 313-766-5882
Mailing address:
  • Phone: 734-255-4000
  • Fax: 313-766-5882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. REBEKAH DOVE MONTGOMERY
Title or Position: OWNER
Credential: PHD, LPC-S
Phone: 734-255-4000