MEDICARE: KAMAL TAYMOUR PSYCHOLOGICAL COUNSELING SERVICES

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1881558336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAMAL TAYMOUR PSYCHOLOGICAL COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	2575 SPRING ARBOR RD STE 300
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-3652
Country	:	US
Telephone Number	:	517-745-6228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2575 SPRING ARBOR RD STE 300
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-3652
Country	:	US
Telephone Number	:	517-745-6228
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAMAL GHAZI
Credential	:	DBH, LCSW-IL, MHA
Telephone Number	:	517-745-6228

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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