| Beautiful Mind Family Counseling Services, Llc | |
|
15056 Colbert St. 03 Romulus MI 48174-4817 | |
| (313) 401-2655 | |
| Not Available |
| Full Name | Beautiful Mind Family Counseling Services, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 15056 Colbert St., Romulus, Michigan |
| Authorized Official Name and Position | Lacara S Gilmore (OWNER/OPERATOR) |
| Authorized Official Contact | 7344048729 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Mind Family Counseling Services, Llc 15056 Colbert St. 03 Romulus MI 48174-4817 Ph: (313) 401-2655 | Beautiful Mind Family Counseling Services, Llc 15056 Colbert St. 03 Romulus MI 48174-4817 Ph: (313) 401-2655 |
| NPI Number | 1568964872 |
|---|---|
| Provider Enumeration Date | 03/02/2018 |
| Last Update Date | 05/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568964872 | NPI | - | NPPES |
| 00069 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (Michigan) | Primary |
| 106H00000X | Marriage & Family Therapist | 4101006791 (Michigan) | Secondary |
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