Provider Demographics
NPI:1891365680
Name:ALTAMIRA COUNSELING PLLC
Entity Type:Organization
Organization Name:ALTAMIRA COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALPI
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-219-9544
Mailing Address - Street 1:200 S WING ST UNIT 5269
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1843
Mailing Address - Country:US
Mailing Address - Phone:248-219-9544
Mailing Address - Fax:
Practice Address - Street 1:340 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1290
Practice Address - Country:US
Practice Address - Phone:248-219-9544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty