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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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