Healthcare Provider Details

I. General information

NPI: 1902621402
Provider Name (Legal Business Name): PROLIFIC CARE PSYCHOLOGICAL & COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8248 MANSFIELD ST
DETROIT MI
48228-1948
US

IV. Provider business mailing address

8248 MANSFIELD ST
DETROIT MI
48228-1948
US

V. Phone/Fax

Practice location:
  • Phone: 313-980-8288
  • Fax:
Mailing address:
  • Phone: 313-980-8288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: APRIL JACKSON
Title or Position: MANAGER
Credential: COUNSELOR
Phone: 313-980-8288