Healthcare Provider Details

I. General information

NPI: 1790466092
Provider Name (Legal Business Name): HENRY PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3135 S STATE ST STE 350G
ANN ARBOR MI
48108-1699
US

IV. Provider business mailing address

1115 PEARL ST
YPSILANTI MI
48197-4620
US

V. Phone/Fax

Practice location:
  • Phone: 734-249-9338
  • Fax:
Mailing address:
  • Phone: 734-249-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KAREN HENRY
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSY.D
Phone: 734-249-9338