Healthcare Provider Details

I. General information

NPI: 1881558336
Provider Name (Legal Business Name): KAMAL TAYMOUR PSYCHOLOGICAL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 SPRING ARBOR RD STE 300
JACKSON MI
49203-3652
US

IV. Provider business mailing address

2575 SPRING ARBOR RD STE 300
JACKSON MI
49203-3652
US

V. Phone/Fax

Practice location:
  • Phone: 517-745-6228
  • Fax:
Mailing address:
  • Phone: 517-745-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAMAL GHAZI
Title or Position: OWNER
Credential: DBH, LCSW-IL, MHA
Phone: 517-745-6228