Provider Demographics
NPI:1386756153
Name:SOUTHWEST COUNSELING SOLUTIONS
Entity type:Organization
Organization Name:SOUTHWEST COUNSELING SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-481-3102
Mailing Address - Street 1:1700 WATERMAN
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48209-2022
Mailing Address - Country:US
Mailing Address - Phone:313-841-8900
Mailing Address - Fax:313-841-2276
Practice Address - Street 1:1700 WATERMAN
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-2022
Practice Address - Country:US
Practice Address - Phone:313-841-8900
Practice Address - Fax:313-841-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-02-17
Deactivation Date:2023-01-10
Deactivation Code:
Reactivation Date:2023-02-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910836OtherBCBS
0H26433Medicare ID - Type Unspecified