MEDICARE: ASHLEY CASALOU MA LPC LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1841891363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY CASALOU MA LPC LLC

Provider Business Mailing Address
First Line	:	36400 WOODWARD AVE STE 20
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-0914
Country	:	US
Telephone Number	:	313-744-2496
Fax Number	:

Provider Business Practice Location Address
First Line	:	36400 WOODWARD AVE STE 20
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-0914
Country	:	US
Telephone Number	:	313-744-2496
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL DIRECTOR
Name	:	ASHLEY CASALOU
Credential	:	MA LPC CCTP
Telephone Number	:	313-744-2496

Provider Enumeration Date	:	11/02/2020
Last Update Date	:	05/04/2026

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