Healthcare Provider Details

I. General information

NPI: 1386110229
Provider Name (Legal Business Name): ANXIETY AND OCD TREATMENT CENTER OF ANN ARBOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 W LIBERTY ST
ANN ARBOR MI
48103-6560
US

IV. Provider business mailing address

2610 W LIBERTY ST
ANN ARBOR MI
48103-6560
US

V. Phone/Fax

Practice location:
  • Phone: 734-368-9691
  • Fax: 833-633-6171
Mailing address:
  • Phone: 734-368-9691
  • Fax: 833-633-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMY PLAVNICK
Title or Position: CO-OWNER
Credential: LMSW
Phone: 734-368-9691