Healthcare Provider Details

I. General information

NPI: 1821219536
Provider Name (Legal Business Name): CENTER FOR FAMILY PSYCHIATRY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 INDUSTRIAL DR STE 4
SALINE MI
48176-1742
US

IV. Provider business mailing address

1235 INDUSTRIAL DR STE 4
SALINE MI
48176-1742
US

V. Phone/Fax

Practice location:
  • Phone: 734-944-8300
  • Fax: 734-944-8303
Mailing address:
  • Phone: 734-944-8300
  • Fax: 734-944-8303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVI SINGH KIRBAT
Title or Position: CLINICAL DIRECTOR
Credential: MD
Phone: 734-944-8300