Healthcare Provider Details

I. General information

NPI: 1609466085
Provider Name (Legal Business Name): RESET COUNSELING & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 W BIG BEAVER RD
TROY MI
48084-4736
US

IV. Provider business mailing address

888 W BIG BEAVER RD
TROY MI
48084-4736
US

V. Phone/Fax

Practice location:
  • Phone: 480-309-6393
  • Fax:
Mailing address:
  • Phone: 480-309-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: CASSANDRA HUCKLEBERRY
Title or Position: OWNER
Credential:
Phone: 480-577-6887