Healthcare Provider Details

I. General information

NPI: 1205774775
Provider Name (Legal Business Name): TACHI RIBEIRO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6390 HAWTHORNE AVE
YPSILANTI MI
48197-3605
US

IV. Provider business mailing address

6390 HAWTHORNE AVE
YPSILANTI MI
48197-3605
US

V. Phone/Fax

Practice location:
  • Phone: 734-291-2607
  • Fax:
Mailing address:
  • Phone: 734-291-2607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TATJANA RIBEIRO
Title or Position: OWNER/THERAPIST
Credential: LLMSW
Phone: 734-291-2607