Healthcare Provider Details

I. General information

NPI: 1437065166
Provider Name (Legal Business Name): SEASON THERAPY STUDIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24634 5 MILE RD
REDFORD MI
48239-3667
US

IV. Provider business mailing address

14513 ARTESIAN ST
DETROIT MI
48223-2226
US

V. Phone/Fax

Practice location:
  • Phone: 313-702-4374
  • Fax:
Mailing address:
  • Phone: 313-702-4374
  • 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: CORALEEN YVONNE WILSON
Title or Position: OWNER/ MENTAL HEALTH COUNSELOR
Credential: LPC
Phone: 313-501-3227