Healthcare Provider Details

I. General information

NPI: 1194252692
Provider Name (Legal Business Name): TELEBEHAVIORAL HEALTH US
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 BELMONT AVE NE UNIT 26
BELMONT MI
49306-1112
US

IV. Provider business mailing address

PO BOX 26
BELMONT MI
49306-0026
US

V. Phone/Fax

Practice location:
  • Phone: 616-327-2405
  • Fax: 616-259-4214
Mailing address:
  • Phone: 616-327-2405
  • Fax: 616-259-4214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUSAN EMILY MOROZOWICH
Title or Position: OWNER & CEO
Credential: LMSW
Phone: 616-327-2405