=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700630423
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NOOR PSYCHOTHERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2024
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24110 MEADOWBROOK RD STE 109
-----------------------------------------------------
City | NOVI
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48375-3406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-871-7551
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24110 MEADOWBROOK RD STE 109
-----------------------------------------------------
City | NOVI
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48375-3406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-871-7551
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOTHERAPIST
-----------------------------------------------------
Name | KOMAL AKHTER
-----------------------------------------------------
Credential | MA, LLP
-----------------------------------------------------
Telephone | 248-871-7551
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------