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General NPI Number Information
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NPI Number | 1396031084
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Entity Type | Organization
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Legal Business Name | EDEN COUNSELING, LLC
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 159 S HARVEY ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1615
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Country | US
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Telephone | 248-602-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 8512 N CANTON CENTER RD
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City | CANTON
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State | MI
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Zip | 48187-1310
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Country | US
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Telephone | 734-459-1760
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Fax | 734-459-1797
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MRS. ANN SCHUELLER
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Credential | LMSW
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Telephone | 248-602-0322
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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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