Healthcare Provider Details

I. General information

NPI: 1629444328
Provider Name (Legal Business Name): COMPLETE NEUROPSYCHOLOGY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 ORNDORF DR STE G
BRIGHTON MI
48116-2479
US

IV. Provider business mailing address

1056 ORNDORF DR STE G
BRIGHTON MI
48116-2479
US

V. Phone/Fax

Practice location:
  • Phone: 734-386-0041
  • Fax: 734-480-8870
Mailing address:
  • Phone: 734-386-0041
  • Fax: 734-480-8870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERIN MARK
Title or Position: NEUROPSYCHOLOGIST, OWNER, DIRECTOR
Credential: PHD
Phone: 734-386-0041