| Kathy Chen Psyd Pllc | |
|
17376 W 12 Mile Rd Suite 102 Southfield MI 48076-2118 | |
| (312) 479-8193 | |
| Not Available |
| Full Name | Kathy Chen Psyd Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 17376 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Kathy Chen (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3124798193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathy Chen Psyd Pllc 1558 Donna Ave Madison Heights MI 48071-2051 Ph: (312) 479-8193 | Kathy Chen Psyd Pllc 17376 W 12 Mile Rd Suite 102 Southfield MI 48076-2118 Ph: (312) 479-8193 |
| NPI Number | 1265983472 |
|---|---|
| Provider Enumeration Date | 10/23/2016 |
| Last Update Date | 10/23/2016 |
| Medicare PECOS PAC ID | 9739469891 |
|---|---|
| Medicare Enrollment ID | O20161206002443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265983472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kathy Chen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811339534 PECOS PAC ID: 2365764305 Enrollment ID: I20141203000346 |
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