| Ph Psychology Phd/providence Hospital And Medical Centers Inc | |
|
16001 W 9 Mile Rd Southfield MI 48075-4818 | |
| (248) 849-3000 | |
| (248) 849-2244 |
| Full Name | Ph Psychology Phd/providence Hospital And Medical Centers Inc |
|---|---|
| Speciality | Psychologist |
| Location | 16001 W 9 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Sarah Starkel (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2486808121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ph Psychology Phd/providence Hospital And Medical Centers Inc 28000 Dequindre Rd Warren MI 48092-2468 Ph: (248) 680-8000 | Ph Psychology Phd/providence Hospital And Medical Centers Inc 16001 W 9 Mile Rd Southfield MI 48075-4818 Ph: (248) 849-3000 |
| NPI Number | 1528023587 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 06/28/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528023587 | NPI | - | NPPES |
| 680F371930 | Other | MI | MI BLUE CROSS GROUP PIN # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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