Provider Demographics
NPI:1669034112
Name:THERAPY UNCENSORED LLC
Entity Type:Organization
Organization Name:THERAPY UNCENSORED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST-
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORTCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-247-8738
Mailing Address - Street 1:16119 FENMORE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3420
Mailing Address - Country:US
Mailing Address - Phone:313-247-8738
Mailing Address - Fax:
Practice Address - Street 1:16119 FENMORE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3420
Practice Address - Country:US
Practice Address - Phone:313-247-8738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty