Healthcare Provider Details

I. General information

NPI: 1083445977
Provider Name (Legal Business Name): CHAUNTE' ROBERTS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHAUNTE' ROBERTS

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34290 FORD RD
WESTLAND MI
48185-3051
US

IV. Provider business mailing address

17235 EUCLID AVE
ALLEN PARK MI
48101-2828
US

V. Phone/Fax

Practice location:
  • Phone: 888-813-8326
  • Fax:
Mailing address:
  • Phone: 248-919-8260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023876
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: