Healthcare Provider Details

I. General information

NPI: 1073211710
Provider Name (Legal Business Name): POSSIBILITIES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 KINGSWAY CT
TRENTON MI
48183-1962
US

IV. Provider business mailing address

1600 KINGSWAY CT
TRENTON MI
48183-1962
US

V. Phone/Fax

Practice location:
  • Phone: 734-307-0124
  • Fax:
Mailing address:
  • Phone: 734-307-0124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MICHEL LYNN DEJULIAN
Title or Position: CLINICAL SOCIAL WORKER
Credential: LMSW
Phone: 734-307-0124