Healthcare Provider Details

I. General information

NPI: 1306102025
Provider Name (Legal Business Name): BEYOND EXPECTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4086 ROCHESTER RD SUITE 202
TROY MI
48085-4945
US

IV. Provider business mailing address

PO BOX 2063
SOUTHFIELD MI
48037-2063
US

V. Phone/Fax

Practice location:
  • Phone: 313-717-6255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401006903
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301012154
License Number StateMI

VIII. Authorized Official

Name: LINDA T CURTIS
Title or Position: CLINICIAN/OWNER
Credential: MA
Phone: 313-717-6255