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General NPI Number Information
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NPI Number | 1356948699
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Entity Type | Individual
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Provider Name | BRENDA HABBO MA, LPC, SCL
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Gender | Female
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 6548 TOWN CENTER DR STE D
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City | CLARKSTON
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State | MI
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Zip | 48346-4823
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Country | US
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Telephone | 800-693-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 4418 ROCHESTER RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-2041
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Country | US
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Telephone | 586-604-7198
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401223882
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License Number State | MI
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