Organization Active NPI

Good Health and Aging Well on Purpose Counseling and Coaching Center P

  • Mental Health Counselor
  • Southfield, MI
National Provider Identifier
1427709252
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GOOD HEALTH AND AGING WELL ON PURPOSE COUNSELING AND COACHING CENTER P
Practice address
17344 W 12 Mile Rd Ste 204
Southfield, MI 48076-6321
Phone
(248) 667-1247
Fax
(313) 406-6796
NPI assigned
Jan 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eleanor L Reynolds, LLPCNPI 1689191041
Title
Owner/Therapist
Phone
(248) 667-1247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

17344 W 12 Mile Rd Ste 204
Southfield, MI 48076-6321

Mailing address

PO Box 2355
Dearborn, MI 48123-2355
Phone (248) 667-1247

Other names 1

  • Good Health and Aging Well on Purpose Co Doing business as

National Provider Directory

National Provider Directory

Locations

17344 W 12 Mile Rd
Ste 204
Southfield, MI 48076
Phone (248) 667-1247

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1427709252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2355",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481232355",
            "telephone_number": "248-667-1247",
            "fax_number": "313-406-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17344 W 12 MILE RD STE 204",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480766321",
            "telephone_number": "248-667-1247",
            "fax_number": "313-406-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD HEALTH AND AGING WELL ON PURPOSE COUNSELING AND COACHING CENTER P",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "248-667-1247",
        "authorized_official_credential": "LLPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Health and Aging Well on Purpose Co",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.