MEDICARE: ARBOR HILLS PSYCHOLOGICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	225X00000X	Occupational Therapist
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1972381465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARBOR HILLS PSYCHOLOGICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	6692 SPRING ARBOR RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-9322
Country	:	US
Telephone Number	:	517-750-3869
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 S SANDSTONE RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-8983
Country	:	US
Telephone Number	:	517-750-3869
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MATTHEW SMITH
Credential	:	MA
Telephone Number	:	517-879-9756

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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