Organization
CK PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELENA N KHATIB (OWNER)
(313) 687-4112
Entity
Organization
Contact information
Practice address
215 ANN ARBOR RD W STE 206, PLYMOUTH, MI 48170-2251
(313) 687-4112
Mailing address
48356 WADEBRIDGE DR, CANTON, MI 48187-1225
(734) 306-9507
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336564970
INDIVIDUAL NPI
—
01
—
6301015851
LIMITED LICENSE PSYCHOLOGIST
MI
Enumeration date
01/07/2020
Last updated
08/08/2025
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