Provider Demographics
NPI:1497211569
Name:AMANI LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:AMANI LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:248-228-4982
Mailing Address - Street 1:21586 WOODCREST CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-4242
Mailing Address - Country:US
Mailing Address - Phone:248-228-4982
Mailing Address - Fax:
Practice Address - Street 1:32729 GRAND RIVER AVE STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336
Practice Address - Country:US
Practice Address - Phone:248-228-4982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty