| Prophetic Solutions Professional Counseling, Pllc | |
|
25245 5 Mile Rd Ste 600 Redford MI 48239-3785 | |
| (313) 506-3322 | |
| Not Available |
| Full Name | Prophetic Solutions Professional Counseling, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 25245 5 Mile Rd Ste 600, Redford, Michigan |
| Authorized Official Name and Position | Carla Lewis-moore (OWNER/CLINICAL THERAPIST) |
| Authorized Official Contact | 3135063322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prophetic Solutions Professional Counseling, Pllc 25245 5 Mile Rd Ste 700 Redford MI 48239-3701 Ph: (313) 506-3322 | Prophetic Solutions Professional Counseling, Pllc 25245 5 Mile Rd Ste 600 Redford MI 48239-3785 Ph: (313) 506-3322 |
| NPI Number | 1689078610 |
|---|---|
| Provider Enumeration Date | 10/20/2014 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 4587939012 |
|---|---|
| Medicare Enrollment ID | O20171009001897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689078610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6801085243 (Michigan) | Primary |
| Provider Name | Carla Jean Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912148792 PECOS PAC ID: 1254602253 Enrollment ID: I20171018002003 |
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