Healthcare Provider Details

I. General information

NPI: 1467392902
Provider Name (Legal Business Name): ETERNAL SOLACE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22760 CIVIC CENTER DR
SOUTHFIELD MI
48033-7150
US

IV. Provider business mailing address

26026 TELEGRAPH RD STE 200
SOUTHFIELD MI
48033-2560
US

V. Phone/Fax

Practice location:
  • Phone: 248-788-6608
  • Fax:
Mailing address:
  • Phone: 248-788-6608
  • 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: TEILOR DUNCAN
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 734-560-8264