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General NPI Number Information
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NPI Number | 1003287459
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Entity Type | Organization
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Legal Business Name | BJC COUNSELING AND BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 16175 ASBURY PARK
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City | DETROIT
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State | MI
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Zip | 48235-3656
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Country | US
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Telephone | 313-673-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 16715 ASBURY PARK
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City | DETROIT
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State | MI
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Zip | 48235
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Country | US
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Telephone | 313-673-1992
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | BARBARA CULP
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Credential | LICENSE COUNSELOR
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Telephone | 313-673-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3891164
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License Number State | MI
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