Healthcare Provider Details
I. General information
NPI: 1013380427
Provider Name (Legal Business Name): BRIGHTON FAMILY CENTER, PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2015
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10315 GRAND RIVER RD SUITE 104
BRIGHTON MI
48116-9594
US
IV. Provider business mailing address
10856 MI STATE ROAD 52
MANCHESTER MI
48158-9412
US
V. Phone/Fax
- Phone: 810-229-0844
- Fax: 734-428-0960
- Phone: 810-229-0844
- Fax: 734-428-0960
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 4101005450 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 4101006471 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401012196 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 6301002961 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
WARWICK
DAVID
ARMSTRONG
Title or Position: MANAGER
Credential: PH.D.
Phone: 810-229-0844