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General NPI Number Information
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NPI Number | 1700492154
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Entity Type | Organization
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Legal Business Name | BOUND TOGETHER COUNSELING, PLLC
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 3020 FRANKLIN PARK DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2477
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Country | US
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Telephone | 313-626-0160
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Fax | 586-261-5458
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone | 517-676-9788
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MS. STEFANI ELIZABETH GOERLICH
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Credential | LMSW
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Telephone | 313-626-0160
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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