Provider Demographics
NPI:1053063982
Name:HASSANIEH, SALMA (LPC)
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:
Last Name:HASSANIEH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 LAHSER RD STE 330-1056
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2608
Mailing Address - Country:US
Mailing Address - Phone:810-674-0807
Mailing Address - Fax:
Practice Address - Street 1:26700 LAHSER RD STE 330-1056
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2608
Practice Address - Country:US
Practice Address - Phone:810-674-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health