ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC PLLC NPI 1326580432

NPI Information

NPI: 1326580432
Provider Name: ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC, PLLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

CLIA Number: 23D0371421

Address:
414 S MAIN ST
SUITE 201
ROCHESTER, MI
ZIP 48307
Phone: (248) 568-5180
Get Directions

ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC, PLLC is a professional counselor in Rochester, MI. ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC, PLLC NPI is 1326580432. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

414 S MAIN ST
SUITE 201
ROCHESTER, MI
ZIP 48307
Phone: (248) 568-5180
Fax: (248) 429-2132

The provider's authorized official is Adam G. Hamilton .
The authorized official title is Owner and has the following contact phone number (248) 568-5180.

The CLIA number assigned to this NPI record is 23D0371421 - other with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/7/2016 and was last updated on 6/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	106H00000X	Marriage & Family Therapist		4101006671	MICHIGAN	No
2	101YP2500X	Counselor	Professional	6401011306	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1417247768	OTHER		INDIVIDUAL NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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