Healthcare Provider Details

I. General information

NPI: 1053508788
Provider Name (Legal Business Name): APEX BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19366 ALLEN RD SUITE C
BROWNSTOWN TWP MI
48183-6809
US

IV. Provider business mailing address

19366 ALLEN RD SUITE C
BROWNSTOWN TWP MI
48183-6809
US

V. Phone/Fax

Practice location:
  • Phone: 734-479-0949
  • Fax: 734-479-1637
Mailing address:
  • Phone: 734-479-0949
  • Fax: 734-479-1637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. THOMAS EDGAR JOHNSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW
Phone: 734-479-0949