Healthcare Provider Details

I. General information

NPI: 1639762602
Provider Name (Legal Business Name): EMOTIONAL HEALING BEHAVIORAL HEALTH & ADDICTION SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 WALTON BLVD STE 212-2A
ROCHESTER HILLS MI
48307-6917
US

IV. Provider business mailing address

1202 WALTON BLVD STE 212-2A
ROCHESTER HILLS MI
48307-6917
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-6073
  • Fax:
Mailing address:
  • Phone: 248-266-6073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. SANJAY MURTHY
Title or Position: OWNER
Credential: MD
Phone: 248-421-5591