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NPI Code Detail

MEDICARE: INDIVIDUUM PSYCHOTHERAPY LLC

MEDICARE: INDIVIDUUM PSYCHOTHERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1760322119
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIVIDUUM PSYCHOTHERAPY LLC
Provider Business Mailing Address
First Line : 2222 W GRAND RIVER AVE STE A
Second Line :
City : OKEMOS
State : MI
Zip : 48864-1604
Country : US
Telephone Number : 586-344-7426
Fax Number :
Provider Business Practice Location Address
First Line : 2222 W GRAND RIVER AVE STE A
Second Line :
City : OKEMOS
State : MI
Zip : 48864-1604
Country : US
Telephone Number : 734-808-3769
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL J VALENTI JR.
Credential : PSYD, LLP
Telephone Number : 586-344-7426
Provider Enumeration Date : 03/28/2026
Last Update Date : 05/21/2026

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Directions to “INDIVIDUUM PSYCHOTHERAPY LLC ” Practice Location

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