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General NPI Number Information
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NPI Number | 1205434669
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Entity Type | Organization
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Legal Business Name | GREAT-LAKES RESTORATIVE COUNSELING LLC
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 11800 MERRIMAN RD UNIT 510896
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City | LIVONIA
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State | MI
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Zip | 48151-2075
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Country | US
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Telephone | 248-587-6667
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Fax |
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Provider Business Mailing Address
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Address Line | 11800 MERRIMAN RD UNIT 510896
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City | LIVONIA
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State | MI
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Zip | 48151-2075
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Country | US
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Telephone | 248-587-6667
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Fax |
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Authorized Official
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Title or Position | OWNER. THERAPIST
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Name | YALONDA VICTORIA STEELE
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Credential |
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Telephone | 586-935-2591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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