MEDICARE: MRS. CHRISTIE LEE AZZAM MA, LLP, LLPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6401006825	MI
2	103T00000X	Psychologist	6301010402	MI

General Provider Information

NPI Number	:	1003956608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTIE LEE AZZAM MA, LLP, LLPC

Provider Business Mailing Address
First Line	:	7518 ACORN HILL CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-4016
Country	:	US
Telephone Number	:	248-761-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	7457 FRANKLIN RD
Second Line	:	SUITE 303
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3611
Country	:	US
Telephone Number	:	248-761-5810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	09/11/2025

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