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General NPI Number Information
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NPI Number | 1144935198
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Entity Type | Organization
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Legal Business Name | THE UPPER ROOM PROFESSIONAL COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 221 N SHELDON RD
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City | PLYMOUTH
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State | MI
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Zip | 48170-1524
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Country | US
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Telephone | 734-748-4005
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Fax | 734-468-0217
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Provider Business Mailing Address
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Address Line | 13173 ANDOVER DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-8208
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Country | US
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Telephone | 734-748-5988
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Fax | 734-468-0217
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Authorized Official
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Title or Position | CLINICAL DIRECTOR MEMBER
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Name | PAMELA HAASE
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Credential | LPC
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Telephone | 734-748-5988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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