Healthcare Provider Details

I. General information

NPI: 1295559003
Provider Name (Legal Business Name): INCLUSIVE MINDS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29800 HARPER AVE STE 3
SAINT CLAIR SHORES MI
48082-1655
US

IV. Provider business mailing address

29800 HARPER AVE STE 3
SAINT CLAIR SHORES MI
48082-1655
US

V. Phone/Fax

Practice location:
  • Phone: 586-279-9760
  • Fax:
Mailing address:
  • Phone: 586-279-9760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY LYNN MONREAL
Title or Position: OWNER/CLINICAL SOCIAL WORKER
Credential: LMSW
Phone: 586-279-9760