Provider Demographics
NPI:1386002665
Name:BREAKTHROUGH COUNSELING, LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NYKIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:313-535-1019
Mailing Address - Street 1:26847 GRAND RIVER AVE
Mailing Address - Street 2:STE. 20
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1544
Mailing Address - Country:US
Mailing Address - Phone:313-535-1019
Mailing Address - Fax:313-535-1019
Practice Address - Street 1:26847 GRAND RIVER AVE
Practice Address - Street 2:STE. 20
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1544
Practice Address - Country:US
Practice Address - Phone:313-535-1019
Practice Address - Fax:313-535-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health