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Organization

REAL IMPACT BEHAVIORAL HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DOROTHEA FOSTER LPC (CEO)
(313) 920-9046
Entity
Organization

Contact information

Practice address
29623 NORTHWESTERN HWY STE 6, SOUTHFIELD, MI 48034-1076
(313) 920-9046
(313) 731-1991
Mailing address
628 PINGREE ST, DETROIT, MI 48202-2024
(313) 920-9046
(313) 731-1991

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
1041C0700X
Clinical Social Worker

Other

Enumeration date
04/21/2026
Last updated
04/21/2026
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