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General NPI Number Information
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NPI Number | 1063856599
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Entity Type | Organization
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Legal Business Name | DAYLIGHT COUNSELING
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 33300 WARREN RD SUITE 17
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City | WESTLAND
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State | MI
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Zip | 48185-9627
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Country | US
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Telephone | 734-331-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 33300 WARREN RD STE 13
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City | WESTLAND
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State | MI
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Zip | 48185-9627
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Country | US
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Telephone | 734-331-0773
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Fax | 734-212-2120
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | MARILYN KISTLER
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Credential | MA, LPC
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Telephone | 734-331-0773
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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 | 6401010853
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License Number State | MI
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