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General NPI Number Information
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NPI Number | 1609260983
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Entity Type | Individual
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Provider Name | DESIREE ALLEN
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2715 MACOMB ST
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City | DETROIT
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State | MI
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Zip | 48207-3830
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Country | US
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Telephone | 313-567-0221
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Fax | 313-567-0239
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 3A
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-874-4806
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Fax | 313-876-1305
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | L219890
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401020227
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | L219890
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License Number State | MI
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