Northern Michigan Psychiatric Services PC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

NORTHERN MICHIGAN PSYCHIATRIC SERVICES PC

Practice address

3287 Racquet Club Dr Unit a
Traverse City, MI 49684-4702

Phone

(231) 935-0355

Fax

(231) 935-0360

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

Sander Weckstein, M.D.

Title

President

Phone

(231) 935-0355

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962414805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496016024",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3287 RACQUET CLUB DR UNIT A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844702",
            "telephone_number": "231-935-0355",
            "fax_number": "231-935-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MICHIGAN PSYCHIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WECKSTEIN",
        "authorized_official_first_name": "SANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-935-0355",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northern Michigan Psychiatric Services
• Northern Michigan Vascular Center P.C.
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• Northern Roots Medical Associates P.L.L.C. (Northern Roots Wellness and Medicine)
• Northern Vision Eye Care, PC
• Northern Woods Counseling & Consulting Services, Inc.

• Child & Adolescent Psychiatry Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.