| Professional Psychotherapy Llc | |
|
63 Kercheval Ave Ste 14 Grosse Pointe Farms MI 48236-3656 | |
| (313) 215-1186 | |
| Not Available |
| Full Name | Professional Psychotherapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 63 Kercheval Ave Ste 14, Grosse Pointe Farms, Michigan |
| Authorized Official Name and Position | Nicole Aubrey Runyon (OWNER) |
| Authorized Official Contact | 3132151186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Psychotherapy Llc 73 Hampton Rd Grosse Pointe Shores MI 48236-1316 Ph: (313) 215-1186 | Professional Psychotherapy Llc 63 Kercheval Ave Ste 14 Grosse Pointe Farms MI 48236-3656 Ph: (313) 215-1186 |
| NPI Number | 1558178434 |
|---|---|
| Provider Enumeration Date | 12/14/2024 |
| Last Update Date | 01/03/2025 |
| Certification Date | 01/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558178434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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