Provider Demographics
NPI:1821565219
Name:FELIX-TYUS, DENISE RENEE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:RENEE
Last Name:FELIX-TYUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29623 NORTHWESTERN HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1076
Mailing Address - Country:US
Mailing Address - Phone:248-469-9036
Mailing Address - Fax:248-893-7152
Practice Address - Street 1:29623 NORTHWESTERN HWY STE 5
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1076
Practice Address - Country:US
Practice Address - Phone:248-469-9036
Practice Address - Fax:248-893-7152
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018812101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional