| Outsidethebox Detroit Therapy | |
|
4131 Clippert St Dearborn Hts MI 48125-2732 | |
| (313) 680-0019 | |
| Not Available |
| Full Name | Outsidethebox Detroit Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 4131 Clippert St, Dearborn Hts, Michigan |
| Authorized Official Name and Position | Bradley Allan Lake (CEO/THERAPIST) |
| Authorized Official Contact | 3136800019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outsidethebox Detroit Therapy 23131 Michigan Ave # 1046 Dearborn MI 48124-2020 Ph: (313) 680-0019 | Outsidethebox Detroit Therapy 4131 Clippert St Dearborn Hts MI 48125-2732 Ph: (313) 680-0019 |
| NPI Number | 1003631987 |
|---|---|
| Provider Enumeration Date | 11/18/2024 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003631987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
Integra Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25625 Kennedy St, Dearborn Hts, MI 48127 Phone: 313-550-5174 |