Healthcare Provider Details

I. General information

NPI: 1437262532
Provider Name (Legal Business Name): INTEGRATED FAMILY PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 OKEMOS RD STE 9
OKEMOS MI
48864-2823
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-897-6463
  • Fax: 517-468-6125
Mailing address:
  • Phone: 517-676-9788
  • Fax: 517-676-3438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301036557
License Number StateMI

VIII. Authorized Official

Name: DANIEL T FIELD
Title or Position: OWNER
Credential: MD
Phone: 517-927-7106