| Christine C. Cantrell, Phd, Llc | |
|
3926 Royal Ave Ste A Berkley MI 48072-3436 | |
| (248) 591-2888 | |
| (248) 677-3350 |
| Full Name | Christine C. Cantrell, Phd, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3926 Royal Ave Ste A, Berkley, Michigan |
| Authorized Official Name and Position | Christine Claire Cantrell (OWNER) |
| Authorized Official Contact | 2485912888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine C. Cantrell, Phd, Llc 3926 Royal Ave Ste A Berkley MI 48072-3436 Ph: (248) 591-2888 | Christine C. Cantrell, Phd, Llc 3926 Royal Ave Ste A Berkley MI 48072-3436 Ph: (248) 591-2888 |
| NPI Number | 1417280546 |
|---|---|
| Provider Enumeration Date | 09/08/2009 |
| Last Update Date | 11/14/2021 |
| Certification Date | 11/14/2021 |
| Medicare PECOS PAC ID | 7416095369 |
|---|---|
| Medicare Enrollment ID | O20091112000612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417280546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6301009340 (Michigan) | Primary |
| Provider Name | Christine Claire Cantrell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134170376 PECOS PAC ID: 0446398390 Enrollment ID: I20091112000590 |
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