Organization
IMPACT LIFE SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEY MAYS DMIN (OWNER / THERAPIST)
(248) 571-4806
Entity
Organization
Contact information
Practice address
4204 BUCKINGHAM AVE, DETROIT, MI 48224-3539
(248) 571-4806
Mailing address
4204 BUCKINGHAM AVE, DETROIT, MI 48224-3539
(248) 571-4806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/23/2023
Last updated
10/24/2023
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