Provider Demographics
NPI:1972141406
Name:RELIANCE COUNSELING, LLC.
Entity Type:Organization
Organization Name:RELIANCE COUNSELING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CADC
Authorized Official - Phone:734-377-8720
Mailing Address - Street 1:11126 WAYNE RD # 2
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-1473
Mailing Address - Country:US
Mailing Address - Phone:734-377-8720
Mailing Address - Fax:734-527-6183
Practice Address - Street 1:11126 WAYNE RD # 2
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1473
Practice Address - Country:US
Practice Address - Phone:734-377-8720
Practice Address - Fax:734-527-6183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health