Individual
JASMINE KOUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
47818 VAN DYKE AVE, SHELBY TWP, MI 48317-3373
(586) 323-3620
Mailing address
47818 VAN DYKE AVE, SHELBY TWP, MI 48317-3373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401226255
MI
101YM0800X
Mental Health Counselor
Primary
6451023614
MI
101YP2500X
Professional Counselor
Primary
6401226255
MI
104100000X
Social Worker
Primary
0000000000
MI
Other
Enumeration date
01/23/2024
Last updated
08/03/2026
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