Organization
EKONG COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVINIA RUCKES EKONG LMSW (OWNER)
(248) 469-8322
Entity
Organization
Contact information
Practice address
29532 SOUTHFIELD RD, 101, SOUTHFIELD, MI 48076-2023
(248) 469-8322
(248) 423-4249
Mailing address
29532 SOUTHFIELD RD, 101, SOUTHFIELD, MI 48076-2023
(248) 469-8322
(248) 423-4249
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6301015337
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0898217
BCBS
—
Enumeration date
12/06/2007
Last updated
02/02/2016
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