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General NPI Number Information
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NPI Number | 1407573678
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Entity Type | Organization
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Legal Business Name | ALLY MENTAL HEALTH INC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 418 N MAIN ST STE 200
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City | ROYAL OAK
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State | MI
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Zip | 48067-1813
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Country | US
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Telephone | 313-492-6456
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Fax | 262-622-6165
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Provider Business Mailing Address
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Address Line | 418 N MAIN ST STE 200
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City | ROYAL OAK
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State | MI
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Zip | 48067-1813
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Country | US
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Telephone | 313-492-6456
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Fax | 262-622-6165
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER SEYMOUR
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Credential | LPC
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Telephone | 440-251-0038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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