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General NPI Number Information
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NPI Number | 1063281418
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Entity Type | Organization
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Legal Business Name | ENDLESS POSSIBILITIES COUNSELING CLINIC LLC
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Dates
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Enumeration Date | 12/27/2023
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 22901 W INDUSTRIAL DR
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1130
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Country | US
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Telephone | 313-980-1254
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 132
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City | EASTPOINTE
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State | MI
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Zip | 48021-0132
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Country | US
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Telephone | 313-980-1254
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | TRACEE JACKSON
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Credential | LPC
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Telephone | 313-980-1254
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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 |
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License Number State |
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