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Organization
REPAIRER OF THE BREACH COUNSELING AND CONSULTANT SERVICES, LLC
Active
Organization
REPAIRER OF THE BREACH COUNSELING AND CONSULTANT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVONNE BROOKS LCSW (LEAD CLINICIAN)
(313) 451-4239
Entity
Organization
Contact information
Practice address
319 CHANDLER ST, DETROIT, MI 48202-2857
(313) 451-4239
Mailing address
319 CHANDLER ST, DETROIT, MI 48202-2857
(313) 451-4239
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184962763
NPI
—
Enumeration date
01/11/2019
Last updated
01/12/2023
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