Healthcare Provider Details

I. General information

NPI: 1386508869
Provider Name (Legal Business Name): COOL.AUTISTIC.TEACHING(C.A.T),
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

14501 PEARSON ST
OAK PARK MI
48237-2607
US

IV. Provider business mailing address

14501 PEARSON ST
OAK PARK MI
48237-2607
US

V. Phone/Fax

Practice location:
  • Phone: 313-268-4202
  • Fax:
Mailing address:
  • Phone: 313-268-4202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: TONYA FAYE WILEY
Title or Position: CEO
Credential:
Phone: 313-268-4202