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General NPI Number Information
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NPI Number | 1023317864
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Entity Type | Organization
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Legal Business Name | KAIROS COUNSELING CENTER
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 71 N LIVERNOIS RD SUITE F
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1001
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Country | US
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Telephone | 248-884-0224
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Fax | 248-651-0450
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Provider Business Mailing Address
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Address Line | 71 N LIVERNOIS RD SUITE F
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1001
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Country | US
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Telephone | 248-884-0224
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Fax | 248-651-0450
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MRS. ELIZABETH ANNE TALBOT
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Credential | L.M.S.W.
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Telephone | 248-884-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801079628
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License Number State | MI
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