| Adams Behavioral & Psychological Services Pc | |
|
17340 W 12 Mile Rd Ste 205 Southfield MI 48076-6322 | |
| (313) 402-7779 | |
| Not Available |
| Full Name | Adams Behavioral & Psychological Services Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17340 W 12 Mile Rd Ste 205, Southfield, Michigan |
| Authorized Official Name and Position | Allen Russell Adams (CLINICIAN) |
| Authorized Official Contact | 3134027779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adams Behavioral & Psychological Services Pc 17340 W 12 Mile Rd Ste 205 Southfield MI 48076-6322 Ph: (313) 402-7779 | Adams Behavioral & Psychological Services Pc 17340 W 12 Mile Rd Ste 205 Southfield MI 48076-6322 Ph: (313) 402-7779 |
| NPI Number | 1114317476 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 01/26/2015 |
| Medicare PECOS PAC ID | 8820339807 |
|---|---|
| Medicare Enrollment ID | O20190402000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114317476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6801088547 (Michigan) | Primary |
| Provider Name | Allen R Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013175587 PECOS PAC ID: 9537226295 Enrollment ID: I20090324000489 |
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