Provider Demographics
NPI:1639770290
Name:PURE JOURNEY COUNSELING
Entity Type:Organization
Organization Name:PURE JOURNEY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MASOUMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-225-3769
Mailing Address - Street 1:2820 W MAPLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7064
Mailing Address - Country:US
Mailing Address - Phone:248-225-3769
Mailing Address - Fax:
Practice Address - Street 1:2820 W MAPLE RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7064
Practice Address - Country:US
Practice Address - Phone:248-225-3769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty