Healthcare Provider Details

I. General information

NPI: 1013072164
Provider Name (Legal Business Name): RAYMOND KAMOO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAY KAMOO PHD

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 03/08/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30200 TELEGRAPH RD STE 207
BINGHAM FARMS MI
48025-5711
US

IV. Provider business mailing address

30200 TELEGRAPH RD STE 207
BINGHAM FARMS MI
48025-5711
US

V. Phone/Fax

Practice location:
  • Phone: 248-712-1129
  • Fax: 248-792-3249
Mailing address:
  • Phone: 248-712-1129
  • Fax: 248-792-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301007666
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number822164
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: