Healthcare Provider Details

I. General information

NPI: 1881293819
Provider Name (Legal Business Name): BREAKTHROUGH CHRISTIAN COUNSELING L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37878 JEFFERSON AVE
HARRISON TWP MI
48045-4000
US

IV. Provider business mailing address

37878 JEFFERSON AVE
HARRISON TWP MI
48045-4000
US

V. Phone/Fax

Practice location:
  • Phone: 734-778-4706
  • Fax:
Mailing address:
  • Phone: 734-778-4706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TERRENCE FLINT
Title or Position: COUNSELOR
Credential:
Phone: 734-778-4706