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General NPI Number Information
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NPI Number | 1700550720
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Entity Type | Organization
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Legal Business Name | AIM BRIGHT COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 888 W BIG BEAVER RD
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City | TROY
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State | MI
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Zip | 48084-4736
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Country | US
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Telephone | 248-264-3113
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Fax | 248-266-2251
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Provider Business Mailing Address
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Address Line | 29793 SPRING HILL DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-1859
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Country | US
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Telephone | 734-674-2561
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Fax | 248-266-2251
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | MARSHONDRA KALI LAWRENCE
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Credential | MDIV, LPC
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Telephone | 734-674-2561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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