Healthcare Provider Details

I. General information

NPI: 1780198879
Provider Name (Legal Business Name): HEGIRA HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 N WAYNE RD STE 210
WESTLAND MI
48185-1137
US

IV. Provider business mailing address

37450 SCHOOLCRAFT RD STE 110
LIVONIA MI
48150-1000
US

V. Phone/Fax

Practice location:
  • Phone: 734-523-8250
  • Fax: 734-523-8215
Mailing address:
  • Phone: 734-458-4601
  • Fax: 734-458-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROL ZUNIGA
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 735-499-1513