Provider Demographics
NPI:1205964459
Name:EL SHADDAI COUNSELING & CONSULTATION SERVICES
Entity type:Organization
Organization Name:EL SHADDAI COUNSELING & CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-240-0372
Mailing Address - Street 1:PO BOX 2568
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-7568
Mailing Address - Country:US
Mailing Address - Phone:734-240-0372
Mailing Address - Fax:734-240-0372
Practice Address - Street 1:105 E FRONT ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-2477
Practice Address - Country:US
Practice Address - Phone:734-240-0372
Practice Address - Fax:734-240-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty