Healthcare Provider Details

I. General information

NPI: 1285495788
Provider Name (Legal Business Name): CHRISTINA MARIE BYRD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48673 HAYES RD
SHELBY TOWNSHIP MI
48315-4403
US

IV. Provider business mailing address

29750 HARPER AVE
SAINT CLAIR SHORES MI
48082-2607
US

V. Phone/Fax

Practice location:
  • Phone: 586-745-9020
  • Fax: 586-777-7855
Mailing address:
  • Phone: 586-777-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225914
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: