Provider Demographics
NPI:1629436100
Name:ZOE COUNSELING SERVICES
Entity Type:Organization
Organization Name:ZOE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-587-6483
Mailing Address - Street 1:PO BOX 40401
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-0401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:248-327-3565
Practice Address - Street 1:24901 NORTHWESTERN HWY STE 314E
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2207
Practice Address - Country:US
Practice Address - Phone:313-401-0990
Practice Address - Fax:248-327-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012944101Y00000X
MI6401011252101YP2500X
MISC0000000841027101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty