Organization
RADIATE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEAH J ETHIER MA, LPC (OWNER)
(248) 872-9526
Entity
Organization
Contact information
Practice address
3190 ROCHESTER RD STE 106, TROY, MI 48083-5464
(877) 727-4463
Mailing address
5283 BLAIR DR, TROY, MI 48085-4034
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780777854
NATIONAL PROVIDER IDENTIFICATION
—
Enumeration date
12/03/2018
Last updated
06/11/2019
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