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General NPI Number Information
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NPI Number | 1902099377
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Entity Type | Organization
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Legal Business Name | A HEALING PLACE FAMILY COUNSELING
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 119 KERCHEVAL AVE SUITE 1A
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3696
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Country | US
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Telephone | 313-300-9232
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Fax |
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Provider Business Mailing Address
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Address Line | 332 CHALFONTE AVE
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-2931
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Country | US
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Telephone | 313-300-9232
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Fax |
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Authorized Official
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Title or Position | CEO, PRESIDENT, SOLE PROPRIETOR
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Name | MRS. ERIN ANN WILLIAMS
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Credential | MSW, LMSW
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Telephone | 313-300-9232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801086813
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License Number State | MI
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