| Carole West Phd, Pllc | |
|
603 N Gainsborough Ave Royal Oak MI 48067-1938 | |
| (248) 607-3455 | |
| (248) 592-7053 |
| Full Name | Carole West Phd, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 603 N Gainsborough Ave, Royal Oak, Michigan |
| Authorized Official Name and Position | Carole E. West (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2486073455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carole West Phd, Pllc 603 N Gainsborough Ave Royal Oak MI 48067-1938 Ph: (248) 607-3455 | Carole West Phd, Pllc 603 N Gainsborough Ave Royal Oak MI 48067-1938 Ph: (248) 607-3455 |
| NPI Number | 1144513847 |
|---|---|
| Provider Enumeration Date | 05/27/2011 |
| Last Update Date | 02/07/2019 |
| Medicare PECOS PAC ID | 3779760640 |
|---|---|
| Medicare Enrollment ID | O20110601000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144513847 | NPI | - | NPPES |
| MI4555 | Other | MI | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301014339 (Michigan) | Primary |
| Provider Name | Carole West |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699076950 PECOS PAC ID: 2769669639 Enrollment ID: I20110601000324 |
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