Healthcare Provider Details
I. General information
NPI: 1629771944
Provider Name (Legal Business Name): RED CARDINAL THERAPY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3145 S FENTON RD
HOLLY MI
48442-9102
US
IV. Provider business mailing address
3145 S FENTON RD
HOLLY MI
48442-9102
US
V. Phone/Fax
- Phone: 248-981-4299
- Fax:
- Phone: 248-660-9640
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HALIE
BYRD
Title or Position: THERAPIST
Credential: LMSW
Phone: 248-660-9640