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General NPI Number Information
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NPI Number | 1225597669
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Entity Type | Organization
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Legal Business Name | STOP THE VIOLENCE PREVENTION OUTREACH PROGRAM
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 28820 SOUTHFIELD RD STE 124
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2775
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Country | US
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Telephone | 313-221-3000
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Fax | 844-500-0445
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Provider Business Mailing Address
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Address Line | 28820 SOUTHFIELD RD STE 124
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2775
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Country | US
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Telephone | 313-221-3000
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Fax | 844-500-0445
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Authorized Official
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Title or Position | CONFLICT RESOLUTION CONSULTANT/CEO
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Name | DR. JOYCE JONES
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Credential | DOCTORATE DIVINITY
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Telephone | 313-221-3000
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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