Healthcare Provider Details

I. General information

NPI: 1457051054
Provider Name (Legal Business Name): PIERRE HALABU MS, TLLP, LLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 15 MILE RD STE A
STERLING HEIGHTS MI
48310-4842
US

IV. Provider business mailing address

28849 HEARTHSTONE DR
NOVI MI
48377-2722
US

V. Phone/Fax

Practice location:
  • Phone: 586-983-9280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: