Provider Demographics
NPI:1952057895
Name:FAITH CENTERED COUNSELING, LLC
Entity Type:Organization
Organization Name:FAITH CENTERED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-568-6401
Mailing Address - Street 1:189 WEST CLARKSTON RD.
Mailing Address - Street 2:BLDG. B, STE 210, BOX#12
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362
Mailing Address - Country:US
Mailing Address - Phone:248-568-6401
Mailing Address - Fax:
Practice Address - Street 1:189 W CLARKSTON RD STE 210
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2892
Practice Address - Country:US
Practice Address - Phone:248-568-6401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty