| Stacy K Doctoroff Llpc, Llc | |
|
29260 Franklin Rd Ste 111 Southfield MI 48034-1196 | |
| (248) 259-5642 | |
| Not Available |
| Full Name | Stacy K Doctoroff Llpc, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 29260 Franklin Rd Ste 111, Southfield, Michigan |
| Authorized Official Name and Position | Stacy K Doctoroff (MEMBER/COUNSELOR) |
| Authorized Official Contact | 2482595642 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy K Doctoroff Llpc, Llc 26413 Huntington Rd Huntington Woods MI 48070-1263 Ph: (248) 259-5642 | Stacy K Doctoroff Llpc, Llc 29260 Franklin Rd Ste 111 Southfield MI 48034-1196 Ph: (248) 259-5642 |
| NPI Number | 1376017137 |
|---|---|
| Provider Enumeration Date | 01/15/2019 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 0941642748 |
|---|---|
| Medicare Enrollment ID | O20240524001175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376017137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stacy K Doctoroff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437445228 PECOS PAC ID: 7214479153 Enrollment ID: I20240607000275 |
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