Prestige Behavioral Therapy Development Center LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PRESTIGE BEHAVIORAL THERAPY DEVELOPMENT CENTER LLC

Practice address

28249 Bell Rd
Southfield, MI 48034

Phone

(313) 492-6007

Fax

(866) 496-9908

NPI assigned

Jan 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Dupree

Title

Owner/Ceo

Phone

(313) 492-6007

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1124365341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28249 BELL RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345141",
            "telephone_number": "313-492-6007",
            "fax_number": "866-496-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28249 BELL RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "313-492-6007",
            "fax_number": "866-496-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE BEHAVIORAL THERAPY DEVELOPMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "DUPREE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "313-492-6007"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.