A Safe Place Counselling and Community Support Services L3C

Organization Active NPI Mental Health Counselor · Detroit, MI

NPI 1487280848 · NPPES record last updated Jan 3, 2025

Key facts

NPI
1487280848
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
A SAFE PLACE COUNSELLING AND COMMUNITY SUPPORT SERVICES L3C
Practice address
20216 Albany St
Detroit, MI 48234-2505
Phone
(313) 384-4783
NPI assigned
Mar 18, 2020
Organization subpart
No

Authorized official

Name
Tina Diane Ealey, MA NPI 1649831280
Title
Professional Counselor
Phone
(313) 384-4783

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

Practitioners 1

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

National Provider Directory

Locations

20222 Albany St
Detroit, MI 48234

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

20216 Albany St
Detroit, MI 48234-2505

Mailing address

20222 Albany St
Detroit, MI 48234-2505

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 3, 2025.

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1487280848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20222 ALBANY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482342505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20216 ALBANY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482342505",
            "telephone_number": "313-384-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SAFE PLACE COUNSELLING AND COMMUNITY SUPPORT SERVICES L3C",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "EALEY",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "313-384-4783",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

All providers in Detroit, MI · Mental Health Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.