Provider Demographics
NPI:1992262505
Name:STELLAR POINTE COUNSELING & PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:STELLAR POINTE COUNSELING & PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-262-7396
Mailing Address - Street 1:21650 W 11 MILE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3715
Mailing Address - Country:US
Mailing Address - Phone:248-262-7396
Mailing Address - Fax:
Practice Address - Street 1:21650 W 11 MILE RD STE 107
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3715
Practice Address - Country:US
Practice Address - Phone:248-798-5457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)