Healthcare Provider Details

I. General information

NPI: 1265291470
Provider Name (Legal Business Name): KEYS OF EMPOWERMENT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18470 W 10 MILE RD STE 200
SOUTHFIELD MI
48075-2603
US

IV. Provider business mailing address

47637 BURLINGAME DR
CHESTERFIELD MI
48047-6028
US

V. Phone/Fax

Practice location:
  • Phone: 313-513-5695
  • Fax: 833-636-6592
Mailing address:
  • Phone: 313-623-9112
  • Fax: 833-636-6592

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: RAPHAEL ANTONIO TRAMBLE
Title or Position: LEAD CLINICAL THERAPIST
Credential: LMSW
Phone: 313-623-9112