Healthcare Provider Details

I. General information

NPI: 1821956541
Provider Name (Legal Business Name): STEPHEN J. VANGEL JR, PH.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3756 ELLISIA RD
COMMERCE TOWNSHIP MI
48382-1724
US

IV. Provider business mailing address

3756 ELLISIA RD
COMMERCE TOWNSHIP MI
48382-1724
US

V. Phone/Fax

Practice location:
  • Phone: 248-842-2930
  • Fax: 248-565-2482
Mailing address:
  • Phone: 248-842-2930
  • Fax: 248-565-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN JAMES VANGEL JR.
Title or Position: MANAGER
Credential: PH.D.
Phone: 248-842-2930