MEDICARE: POSITIVE VIBRATION

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1548120124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE VIBRATION

Provider Business Mailing Address
First Line	:	16821 MARK TWAIN ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-4066
Country	:	US
Telephone Number	:	313-999-8724
Fax Number	:

Provider Business Practice Location Address
First Line	:	16821 MARK TWAIN ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-4066
Country	:	US
Telephone Number	:	313-999-8724
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL BLAIR-HOUSTON
Credential	:	, MSN PMHNP-BC
Telephone Number	:	313-999-8724

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	01/12/2026

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Directions to “POSITIVE VIBRATION ” Practice Location

Language	Start Address	Practice Location

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