Provider Demographics
NPI:1386232296
Name:TIME OF GLORY COUNSELING SERVICES
Entity Type:Organization
Organization Name:TIME OF GLORY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NYREIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-739-2376
Mailing Address - Street 1:8237 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-7923
Mailing Address - Country:US
Mailing Address - Phone:248-739-2376
Mailing Address - Fax:
Practice Address - Street 1:24100 SOUTHFIELD RD STE 320H
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2865
Practice Address - Country:US
Practice Address - Phone:248-739-2376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
923135153OtherBLUE CROSS BLUE SHIELD