Provider Demographics
NPI:1295915643
Name:MOTIVATIONAL EMPOWERMENT COUNSELING CENTER & ASSOCIATES
Entity type:Organization
Organization Name:MOTIVATIONAL EMPOWERMENT COUNSELING CENTER & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:DEJUAN
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC, CAAC, CCS-M
Authorized Official - Phone:734-721-0900
Mailing Address - Street 1:7845 MIDDLEBELT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-2174
Mailing Address - Country:US
Mailing Address - Phone:734-721-0900
Mailing Address - Fax:
Practice Address - Street 1:7845 MIDDLEBELT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2174
Practice Address - Country:US
Practice Address - Phone:734-721-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI822954251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health