Organization
LIFE WATER COUNSELING & SUPPORT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LATEASE BISHOP-JOHNSON (CEO)
(248) 945-2700
Entity
Organization
Contact information
Practice address
23800 W 10 MILE RD STE 150, SOUTHFIELD, MI 48033-3123
(248) 327-6593
Mailing address
23800 W 10 MILE RD STE 150, SOUTHFIELD, MI 48033-3123
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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