Healthcare Provider Details

I. General information

NPI: 1962190389
Provider Name (Legal Business Name): BE YOU THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12660 10 MILE RD
SOUTH LYON MI
48178-8760
US

IV. Provider business mailing address

1128 CHESTNUT LN
SOUTH LYON MI
48178-1897
US

V. Phone/Fax

Practice location:
  • Phone: 248-290-8197
  • Fax: 248-671-3446
Mailing address:
  • Phone: 248-290-8197
  • Fax: 248-671-3446

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: JACQUELYN MAYOWSKI
Title or Position: OWNER
Credential: MS LPC BCBA
Phone: 248-613-1261