Healthcare Provider Details

I. General information

NPI: 1134055296
Provider Name (Legal Business Name): GAHL BERKOOZ LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31600 TELEGRAPH RD STE 260
BINGHAM FARMS MI
48025-4372
US

IV. Provider business mailing address

2738 S SPURWAY DR
ANN ARBOR MI
48105-2293
US

V. Phone/Fax

Practice location:
  • Phone: 810-295-1527
  • Fax:
Mailing address:
  • Phone: 734-277-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851121544
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: