Detroit Wayne Mental Health Authority
Organization Active NPI Clinical Child & Adolescent Psychologist · Detroit, MI
NPI 1609290451 · NPPES record last updated Oct 24, 2016
Key facts
- NPI
- 1609290451
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- Legal business name
- DETROIT WAYNE MENTAL HEALTH AUTHORITY
- Practice address
- 707 W Milwaukee St
Detroit, MI 48202-2943 - Phone
- (313) 344-9099
- NPI assigned
- Feb 14, 2014
- Organization subpart
- No
Authorized official
- Name
- Mrs. Stacie Durant, CPA
- Title
- Chief Financial Officer
- Phone
- (313) 344-9099
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Detroit Wayne Mental Health Authority
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist |
103TC2200X | Yes | ||
| Family Psychologist |
103TF0000X |
Addresses
Primary practice location
707 W Milwaukee St
Detroit, MI 48202-2943
Mailing address
707 W Milwaukee St
Detroit, MI 48202-2943
Phone (313) 344-9090
Other providers in Detroit, MI
- Detroit Wayne County Health Authority
- Detroit Wayne County Health Authority
- Detroit Wayne Integrated Health Network
- Detroit Wayne Mental Health Authority
- Detroit Wayne Mental Health Authority
- Detroit-Macomb Hospital Corporation
- Ian John Detroyer
- Diane Deutsch-Keahey
- Sarayu Devabhaktuni
- Anupama Devara
All providers in Detroit, MI · Clinical Child & Adolescent Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.