Provider Demographics
NPI:1003287459
Name:BJC COUNSELING AND BEHAVIORAL SERVICES LLC
Entity Type:Organization
Organization Name:BJC COUNSELING AND BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSE COUNSELOR
Authorized Official - Phone:313-673-1992
Mailing Address - Street 1:16715 ASBURY PARK
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-673-1992
Mailing Address - Fax:
Practice Address - Street 1:16175 ASBURY PARK
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3656
Practice Address - Country:US
Practice Address - Phone:313-673-1992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3891164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty