Blaq Therapy

NPI #1609646256 in Mattawan, Michigan

Provider Information

NPI Number: 1609646256
Entity Type: Organization
Organization Name: Blaq Therapy
Primary Specialty: Counselor - Professional
Enumeration Date: Jan 4, 2024
Last Updated: Jan 4, 2024

Practice Location

Address: 24073 CRESCENT ST
City: Mattawan
State: Michigan
ZIP Code: 49071-8457
Phone: (734) 802-7667

Authorized Official

Name: ANTER ABDALLAH
Title: CREDENTIALER
Phone: (734) 802-7667

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Psychologist - Counseling — Counseling	103TC1900X
Social Worker - Clinical — Clinical	1041C0700X
Registered Nurse - Psychiatric/Mental Health — Psychiatric/Mental Health	163WP0808X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Art Therapist	221700000X
Music Therapist	225A00000X
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinical Nurse Specialist - Psychiatric/Mental Health — Psychiatric/Mental Health	364SP0808X
Counselor - Professional — Professional	101YP2500X	Primary

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