Healthcare Provider Details

I. General information

NPI: 1841883832
Provider Name (Legal Business Name): COUNSELING BY CORYANNA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 GOLFSIDE RD STE 10
YPSILANTI MI
48197-1145
US

IV. Provider business mailing address

2111 GOLFSIDE RD STE 10
YPSILANTI MI
48197-1145
US

V. Phone/Fax

Practice location:
  • Phone: 734-787-8966
  • Fax:
Mailing address:
  • Phone: 734-787-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: CORYANNA L KU
Title or Position: CEO AND PSYCHOTHERAPIST
Credential: LPC, NCC
Phone: 734-787-8966