Provider Demographics
NPI:1922630748
Name:HEART AND SOUL COUNSELING AND LIFE COACHING SERVICES
Entity Type:Organization
Organization Name:HEART AND SOUL COUNSELING AND LIFE COACHING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:TYUS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:248-521-6432
Mailing Address - Street 1:29623 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1076
Mailing Address - Country:US
Mailing Address - Phone:248-521-6432
Mailing Address - Fax:248-862-5573
Practice Address - Street 1:29623 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1076
Practice Address - Country:US
Practice Address - Phone:248-521-6432
Practice Address - Fax:248-862-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty