Provider Demographics
NPI:1609466085
Name:RESET COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:RESET COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUCKLEBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-577-6887
Mailing Address - Street 1:888 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4736
Mailing Address - Country:US
Mailing Address - Phone:480-309-6393
Mailing Address - Fax:
Practice Address - Street 1:888 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4736
Practice Address - Country:US
Practice Address - Phone:480-309-6393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIVS0232061Medicaid