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General NPI Number Information
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NPI Number | 1275217531
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Entity Type | Organization
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Legal Business Name | DETROIT THERAPY, LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 600 RIVER PLACE DR APT 6651
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City | DETROIT
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State | MI
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Zip | 48207-5026
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Country | US
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Telephone | 313-799-0709
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Fax |
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Provider Business Mailing Address
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Address Line | 600 RIVER PLACE DR APT 6651
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City | DETROIT
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State | MI
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Zip | 48207-5026
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Country | US
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Telephone | 313-799-0709
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/CEO
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Name | TENAICSHA BOYCE
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Credential | LMSW-C
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Telephone | 313-799-0709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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