| Self Elevation Therapy Llc | |
|
39150 Dequindre Rd # Suire200 Sterling Heights MI 48310-6989 | |
| (248) 444-8582 | |
| Not Available |
| Full Name | Self Elevation Therapy Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 39150 Dequindre Rd # Suire200, Sterling Heights, Michigan |
| Authorized Official Name and Position | Olivia Abouna (OWNER) |
| Authorized Official Contact | 2484448582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Elevation Therapy Llc Po Box 250935 West Bloomfield MI 48325-0935 Ph: () - | Self Elevation Therapy Llc 39150 Dequindre Rd # Suire200 Sterling Heights MI 48310-6989 Ph: (248) 444-8582 |
| NPI Number | 1356051965 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 12/12/2022 |
| Certification Date | 12/12/2022 |
| Medicare PECOS PAC ID | 7214300227 |
|---|---|
| Medicare Enrollment ID | O20230228003041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356051965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Olivia Abouna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619516085 PECOS PAC ID: 4183052715 Enrollment ID: I20200314000043 |
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