Provider Demographics
NPI:1184105173
Name:BRIGHT SPOT COUNSELING PLLC
Entity type:Organization
Organization Name:BRIGHT SPOT COUNSELING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC
Authorized Official - Phone:248-227-8760
Mailing Address - Street 1:32905 W 12 MILE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3345
Mailing Address - Country:US
Mailing Address - Phone:248-296-3104
Mailing Address - Fax:
Practice Address - Street 1:32905 W 12 MILE RD STE 310
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3345
Practice Address - Country:US
Practice Address - Phone:248-296-3104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010923741041C0700X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
12663038OtherCAQH
MI1883825Medicaid
MI6801092374OtherLICENSE