Healthcare Provider Details

I. General information

NPI: 1861609505
Provider Name (Legal Business Name): WEBER AND DEVERS PSYCHOLOGICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E 7TH AVE
SAULT SAINTE MARIE MI
49783
US

IV. Provider business mailing address

605 E 7TH AVE APT 9
SAULT SAINTE MARIE MI
49783-3111
US

V. Phone/Fax

Practice location:
  • Phone: 906-635-7270
  • Fax: 906-635-7688
Mailing address:
  • Phone: 906-635-7270
  • Fax: 906-635-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6803064866
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401002664
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301008585
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301010982
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301009814
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301011252
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801073765
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801020691
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801082175
License Number StateMI
# 10
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801079326
License Number StateMI
# 11
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101006291
License Number StateMI

VIII. Authorized Official

Name: DR. ROBERT JAMES DEVERS
Title or Position: VICE PRESIDENT
Credential: PSY.D.
Phone: 906-635-7270