Counseling and Divorce Mediation Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COUNSELING AND DIVORCE MEDIATION SERVICES, LLC

Practice address

17937 Hall Rd
Macomb, MI 48044-4557

Phone

(586) 707-3331

NPI assigned

Aug 19, 2017

Organization subpart

No

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

Authorized official

Name

Farrah Dababneh, LMSW

Title

Psychotherapist

Phone

(248) 709-7115

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1503100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503100800000",
    "number": "1942726195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43762 HOLMES DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141879",
            "telephone_number": "248-709-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17937 HALL RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444557",
            "telephone_number": "586-707-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND DIVORCE MEDIATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-19",
        "last_updated": "2017-08-19",
        "status": "A",
        "authorized_official_last_name": "DABABNEH",
        "authorized_official_first_name": "FARRAH",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "248-709-7115",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Macomb, MI
• Providers in Macomb, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2017; 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.