Healthcare Provider Details

I. General information

NPI: 1699117317
Provider Name (Legal Business Name): JOSEPH R RIZZO PHD, LP, CAADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 E EDSEL FORD FWY STE 200
DETROIT MI
48202-3742
US

IV. Provider business mailing address

530 S STATE ST STE 4079
ANN ARBOR MI
48109-1303
US

V. Phone/Fax

Practice location:
  • Phone: 248-587-7884
  • Fax:
Mailing address:
  • Phone: 734-764-8312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301016222
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019534
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301016222
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: