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General NPI Number Information
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NPI Number | 1265291470
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Entity Type | Organization
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Legal Business Name | KEYS OF EMPOWERMENT COUNSELING LLC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 17403 WOODINGHAM DR
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City | DETROIT
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State | MI
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Zip | 48221-4505
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Country | US
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Telephone | 586-261-3462
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Fax |
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Provider Business Mailing Address
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Address Line | 47637 BURLINGAME DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-6028
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Country | US
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Telephone | 313-623-9112
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Fax |
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Authorized Official
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Title or Position | LEAD CLINICAL THERAPIST
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Name | RAPHAEL ANTONIO TRAMBLE
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Credential | LMSW
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Telephone | 313-623-9112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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