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NPI Code Detail

MEDICARE: HAPPY MAMA COUNSELING PLLC

MEDICARE: HAPPY MAMA COUNSELING PLLC
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
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16801097752OTHERMILICENSED CLINICAL SOCIAL WORKER - STATE OF MI - LARA

General Provider Information

NPI Number : 1477162592
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAPPY MAMA COUNSELING PLLC
Provider Business Mailing Address
First Line : 17251 W 12 MILE RD STE 200
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48076-2140
Country : US
Telephone Number : 248-416-4644
Fax Number : 833-419-1234
Provider Business Practice Location Address
First Line : 17251 W 12 MILE RD STE 200
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48076-2140
Country : US
Telephone Number : 248-416-4644
Fax Number : 833-419-1234
Authorized Official
Title or Position : OWNER
Name : TINA GUTMAN
Credential : LMSW
Telephone Number : 248-416-4644
Provider Enumeration Date : 07/24/2020
Last Update Date : 08/02/2024

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Directions to “HAPPY MAMA COUNSELING PLLC ” Practice Location

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