Organization
CENTER FOR CONFIDENTIAL COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONA MICKLES-BURNS PHD (OWNER)
(248) 388-1221
Entity
Organization
Contact information
Practice address
16000 W 9 MILE RD, STE 507, SOUTHFIELD, MI 48075-4808
(248) 388-1221
Mailing address
16000 W 9 MILE RD, STE 507, SOUTHFIELD, MI 48075-4808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801046764
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12561898
CAQH
MI
Enumeration date
08/12/2015
Last updated
09/28/2015
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