Healthcare Provider Details

I. General information

NPI: 1619274636
Provider Name (Legal Business Name): DANIEL J. KACHMAN, ED. D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date: 04/28/2014
Reactivation Date: 07/21/2014

III. Provider practice location address

2791 GUELPH CT
NORTH BRANCH MI
48461-7927
US

IV. Provider business mailing address

2791 GUELPH CT
NORTH BRANCH MI
48461-7927
US

V. Phone/Fax

Practice location:
  • Phone: 810-664-4363
  • Fax:
Mailing address:
  • Phone: 810-664-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL JOHN KACHMAN
Title or Position: LICENSED PSYCHOLOGIST
Credential: ED.D.
Phone: 810-664-4363