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Organization

DAWN NEW AWAKENING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DARNICIA L SIMLEY-CALVIN LLPC-CADC-DP (ADMINISTRATOR)
(313) 221-3610
Entity
Organization

Contact information

Practice address
26316 RONALD ST, ROSEVILLE, MI 48066-4458
(313) 221-3610
Mailing address
26316 RONALD ST, ROSEVILLE, MI 48066-4458
(313) 221-3610

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401015231
MI
101YM0800X
Mental Health Counselor
6401015231
MI
101YP1600X
Pastoral Counselor
6401015231
MI
101YP2500X
Professional Counselor
Primary
6401015231
MI
106H00000X
Marriage & Family Therapist
6401015231
MI

Other

Enumeration date
04/03/2017
Last updated
04/03/2017
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