| Conflict Resolution Institute | |
|
2026 Austin Dr Novi MI 48377-1906 | |
| (248) 385-3498 | |
| (810) 213-0555 |
| Full Name | Conflict Resolution Institute |
|---|---|
| Speciality | Clinic/Center |
| Location | 2026 Austin Dr, Novi, Michigan |
| Authorized Official Name and Position | Terence Broussard-bnu (COUNSELOR) |
| Authorized Official Contact | 2483853498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conflict Resolution Institute 2026 Austin Dr Novi MI 48377-1906 Ph: (248) 385-3498 | Conflict Resolution Institute 2026 Austin Dr Novi MI 48377-1906 Ph: (248) 385-3498 |
| NPI Number | 1174002018 |
|---|---|
| Provider Enumeration Date | 08/10/2018 |
| Last Update Date | 01/07/2025 |
| Certification Date | 12/10/2024 |
| Medicare PECOS PAC ID | 6507224698 |
|---|---|
| Medicare Enrollment ID | O20250130001177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174002018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6401016209 (Michigan) | Primary |
| Provider Name | Terence Broussard-bnu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083100655 PECOS PAC ID: 7315305406 Enrollment ID: I20250130001386 |
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