Organization
PERSONAL CHOICE PLANNED CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSLYN JO CARTER MA, LPC (CEO/DIRECTOR)
(313) 363-1976
Entity
Organization
Contact information
Practice address
4432 KNIGHTSBRIDGE LN, WEST BLOOMFIELD, MI 48323-1627
(313) 363-1976
Mailing address
4432 KNIGHTSBRIDGE LN, WEST BLOOMFIELD, MI 48323-1627
(313) 363-1976
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
6401004803
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164502431
—
MI
Enumeration date
08/08/2011
Last updated
11/13/2023
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