BLAQ THERAPY; NPI #1609646256

Contact Information

BLAQ THERAPY

24073 CRESCENT ST
MATTAWAN, MI 49071-8457

Phone: 734-802-7667
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Professional	101YP2500X
Art Therapist	221700000X
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Counseling	103TC1900X	62	Psychologist, Clinical
Mental Health	101YM0800X
Music Therapist	225A00000X
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner
Psychiatric/Mental Health	364SP0808X	89	Certified Clinical Nurse Specialist
Psychiatric/Mental Health	163WP0808X
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for BLAQ THERAPY

NPI #	`1609646256`
LBN Legal business name	BLAQ THERAPY
Authorized official	ANTER ABDALLAH - (CREDENTIALER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/04/2024
Last updated	01/04/2024 - About 2 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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BLAQ THERAPY

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NPI Profile & details for BLAQ THERAPY

Reviews for BLAQ THERAPY