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Organization
STATE OF MIND COUNSELING CENTERS LLC
Active
Organization
STATE OF MIND COUNSELING CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRISSA NICOLE MICHAEL MA, LPC, NCC, LLMFT (OWNER/THERAPIST)
(248) 521-8237
Entity
Organization
Contact information
Practice address
52188 VAN DYKE AVE STE 319, SHELBY TOWNSHIP, MI 48316-3571
(248) 690-6851
Mailing address
140 FONTAINBLEAU CT E, ROCHESTER HILLS, MI 48307-2421
(248) 521-8237
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770927147
NPI
—
Enumeration date
03/24/2019
Last updated
06/11/2019
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