Provider Demographics
NPI:1467831503
Name:AGAPE FAMILY COUNSELING, PLLC
Entity type:Organization
Organization Name:AGAPE FAMILY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:PH,D
Authorized Official - Phone:248-568-3125
Mailing Address - Street 1:1460 WALTON BLVD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1768
Mailing Address - Country:US
Mailing Address - Phone:248-568-3125
Mailing Address - Fax:248-608-6800
Practice Address - Street 1:1460 WALTON BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1768
Practice Address - Country:US
Practice Address - Phone:248-568-3125
Practice Address - Fax:248-608-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012902251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health