Provider Demographics
NPI:1205542685
Name:SHEKINAH GLORY CHRISTIAN COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:SHEKINAH GLORY CHRISTIAN COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:313-300-8191
Mailing Address - Street 1:29260 FRANKLIN RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1144
Mailing Address - Country:US
Mailing Address - Phone:248-716-1252
Mailing Address - Fax:
Practice Address - Street 1:29260 FRANKLIN RD STE 115
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1144
Practice Address - Country:US
Practice Address - Phone:248-716-1252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty