Healthcare Provider Details

I. General information

NPI: 1154248995
Provider Name (Legal Business Name): WHOLISTIC HEALING MINISTRIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 W 10 MILE RD STE 115
SOUTHFIELD MI
48075-2100
US

IV. Provider business mailing address

15700 W 10 MILE RD STE 115
SOUTHFIELD MI
48075-2100
US

V. Phone/Fax

Practice location:
  • Phone: 313-355-4543
  • Fax:
Mailing address:
  • Phone: 313-355-4543
  • 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: JESSICA ROBINSON
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 313-355-4543