Healthcare Provider Details

I. General information

NPI: 1659255594
Provider Name (Legal Business Name): SOUTHWEST COUNSELING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WATERMAN ST
DETROIT MI
48209-2022
US

IV. Provider business mailing address

5716 MICHIGAN AVE STE 3100
DETROIT MI
48210-3039
US

V. Phone/Fax

Practice location:
  • Phone: 313-841-8900
  • Fax:
Mailing address:
  • Phone: 313-963-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AMPHY LILIBET NEGRON
Title or Position: DIRECTOR OF CLINICAL INFORMATICS
Credential:
Phone: 313-963-2266