Healthcare Provider Details

I. General information

NPI: 1831960244
Provider Name (Legal Business Name): THE STANDARD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18585 STEPHENS DR
EASTPOINTE MI
48021-1956
US

IV. Provider business mailing address

18585 STEPHENS DR
EASTPOINTE MI
48021-1956
US

V. Phone/Fax

Practice location:
  • Phone: 810-288-5921
  • Fax:
Mailing address:
  • Phone: 586-345-2925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: BRIANA NICOLE MCNEAL
Title or Position: LCSW PSYCHOTHERAPIST AND DOULA
Credential: LCSW AND DOULA
Phone: 810-288-5921