Organization
TRANSFORMATIVE MIND COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJA BURKS LMSW (CLINICAL SOCIAL WORKER)
(313) 492-8452
Entity
Organization
Contact information
Practice address
17368 W 12 MILE RD STE 201, SOUTHFIELD, MI 48076
(313) 492-8452
(248) 856-3801
Mailing address
18180 MEADOWOOD AVE, LATHRUP VILLAGE, MI 48076-4514
(313) 492-8452
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
08/20/2018
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