Healthcare Provider Details

I. General information

NPI: 1255911962
Provider Name (Legal Business Name): PERSPECTIVES OF TROY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 HOLIDAY TER
KALAMAZOO MI
49009-2196
US

IV. Provider business mailing address

2550 S TELEGRAPH RD STE 250
BLOOMFIELD HILLS MI
48302-0909
US

V. Phone/Fax

Practice location:
  • Phone: 269-372-4140
  • Fax:
Mailing address:
  • Phone: 248-322-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: ELLIOTT RICHELSON
Title or Position: PRESIDENT, TREASURER, SECRETARY
Credential: M.D.
Phone: 904-605-4986