Provider Demographics
NPI:1992819841
Name:BRIGHTSTAR COUNSELING PLLC
Entity type:Organization
Organization Name:BRIGHTSTAR COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:MUQADDAS
Authorized Official - Last Name:AMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-882-2727
Mailing Address - Street 1:653 PERRIEN PLACE
Mailing Address - Street 2:
Mailing Address - City:GROSS POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19925 VERNIER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HARPERS WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-882-2727
Practice Address - Fax:313-882-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty