Prophetic Solutions Professional Counseling, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6801085243 Issued in MI

Legal business name

PROPHETIC SOLUTIONS PROFESSIONAL COUNSELING, PLLC

Practice address

25245 5 Mile Rd Ste 600
Redford, MI 48239-3785

Phone

(313) 506-3322

NPI assigned

Oct 20, 2014

Organization subpart

No

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

Authorized official

Name

Carla Lewis-Moore, LMSWNPI 1912148792

Title

Owner/Clinical Therapist

Phone

(313) 506-3322

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Carla Lewis-Moore, LMSW

  • Clinical Social Worker
  • Redford, MI
  • NPI 1912148792
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1689078610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25245 5 MILE RD",
            "address_2": "STE 700",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393701",
            "telephone_number": "313-506-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25245 5 MILE RD STE 600",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393785",
            "telephone_number": "313-506-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROPHETIC SOLUTIONS PROFESSIONAL COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "LEWIS-MOORE",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "313-506-3322",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801085243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Redford, MI
• Providers in Redford, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.