Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provisional Therapy Associates

Organization Professional Counselor · NPI 1831943026

Provisional Therapy Associates is a Professional Counselor in West Bloomfield, Michigan. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

4241 Breckenridge Dr
West Bloomfield, MI 48322-4430
Phone: (248) 240-2963
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X

Record details

NPI number1831943026
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lina Escamilla — Group Representative · (248) 240-2963
NPI enumeratedApril 15, 2024
Last updated in NPPESApril 15, 2024
Certification dateApril 14, 2024
Mailing address4241 Breckenridge Dr, West Bloomfield, MI 48322-4430

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