Healthcare Provider Details

I. General information

NPI: 1083576441
Provider Name (Legal Business Name): FAITH SERVICES & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12206 MORANG DR
DETROIT MI
48224-1543
US

IV. Provider business mailing address

19458 SORRENTO ST
DETROIT MI
48235-1234
US

V. Phone/Fax

Practice location:
  • Phone: 248-759-7771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
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: NATASHA PURRY
Title or Position: CEO
Credential:
Phone: 248-759-7771