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General NPI Number Information
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NPI Number | 1629436100
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Entity Type | Organization
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Legal Business Name | ZOE COUNSELING SERVICES
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 24901 NORTHWESTERN HWY STE 314E
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2207
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Country | US
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Telephone | 313-401-0990
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Fax | 248-327-3565
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Provider Business Mailing Address
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Address Line | PO BOX 40401
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City | REDFORD
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State | MI
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Zip | 48240-0401
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Country | US
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Telephone |
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Fax | 248-327-3565
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Authorized Official
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Title or Position | CEO
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Name | RENATA BUSH
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Credential | LPC
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Telephone | 313-587-6483
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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 | 6401012944
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | SC0000000841027
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401011252
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License Number State | MI
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