Organization
NUMINA LLC
Active
Organization
NUMINA LLC
Active
Other names
Numina
Organization subpart
No
Provider details
NPI number
Authorized official
AMYNA FTOUNI (CO-OWNER)
(313) 909-4099
Entity
Organization
Contact information
Practice address
835 MASON ST, DEARBORN, MI 48124-2231
(313) 444-9887
Mailing address
5643 DACOSTA ST, DEARBORN HEIGHTS, MI 48127-2415
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
174400000X
Specialist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301016427
BOARD OF PSYCHOLOGY - MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
01
—
6801105547
BOARD OF SOCIAL WORK - MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
01/25/2021
Last updated
04/23/2021
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