Healthcare Provider Details

I. General information

NPI: 1528904091
Provider Name (Legal Business Name): THERAVIBE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27941 URSULINE ST
SAINT CLAIR SHORES MI
48081-3646
US

IV. Provider business mailing address

27941 URSULINE ST
SAINT CLAIR SHORES MI
48081-3646
US

V. Phone/Fax

Practice location:
  • Phone: 810-358-7880
  • Fax:
Mailing address:
  • Phone: 810-358-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA CZEGLEDI
Title or Position: OWNER
Credential: LMSW
Phone: 810-358-7880