Provider Demographics
NPI:1821690819
Name:SUNFISH COUNSELING LLC
Entity Type:Organization
Organization Name:SUNFISH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:734-648-6353
Mailing Address - Street 1:535 GRISWOLD STREET SUITE 111
Mailing Address - Street 2:#306
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226
Mailing Address - Country:US
Mailing Address - Phone:734-648-6353
Mailing Address - Fax:
Practice Address - Street 1:535 GRISWOLD STREET SUITE 111 #306
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-4822
Practice Address - Country:US
Practice Address - Phone:734-648-6353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty