Organization
BLACK MALE THERAPIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN D STUCKEY LMSW (OWNER)
(248) 973-7177
Entity
Organization
Contact information
Practice address
21650 W 11 MILE RD STE 108, SOUTHFIELD, MI 48076-3715
(248) 973-7177
Mailing address
21650 W 11 MILE RD STE 108, SOUTHFIELD, MI 48076-3715
(248) 973-7177
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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