Healthcare Provider Details

I. General information

NPI: 1689907966
Provider Name (Legal Business Name): CENTER FOR BEHAVIORAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S MAIN ST SUITE 210
LAPEER MI
48446-3077
US

IV. Provider business mailing address

700 S MAIN ST SUITE 210
LAPEER MI
48446-3077
US

V. Phone/Fax

Practice location:
  • Phone: 810-245-1660
  • Fax: 810-644-4364
Mailing address:
  • Phone: 810-245-1660
  • Fax: 810-644-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: ERLINDA P MERCADO
Title or Position: OWNER
Credential: M.D.
Phone: 810-245-1660