Healthcare Provider Details

I. General information

NPI: 1124973268
Provider Name (Legal Business Name): HEALTHY HEARTS SOUND MINDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41430 GRAND RIVER AVE STE D
NOVI MI
48375-1876
US

IV. Provider business mailing address

41430 GRAND RIVER AVE STE D
NOVI MI
48375-1876
US

V. Phone/Fax

Practice location:
  • Phone: 586-500-0756
  • Fax: 586-261-3163
Mailing address:
  • Phone: 586-500-0756
  • Fax: 586-261-3163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHARTISHA L HAYSLETT
Title or Position: OWNER
Credential: LLMSW, QMHP, QIDP
Phone: 586-335-8486