Healthcare Provider Details

I. General information

NPI: 1609884550
Provider Name (Legal Business Name): RICHARD GELB PHD ABPN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20500 EUREKA ROAD SUITE 315
TAYLOR MI
48180-5370
US

IV. Provider business mailing address

20500 EUREKA ROAD SUITE 315
TAYLOR MI
48180-5370
US

V. Phone/Fax

Practice location:
  • Phone: 734-324-8930
  • Fax: 734-324-8931
Mailing address:
  • Phone: 734-324-8930
  • Fax: 734-324-8931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301005856
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301005856
License Number StateMI

VIII. Authorized Official

Name: MR. RICHARD GELB
Title or Position: PRES OF RICHARD GELB PHD ABPN PC
Credential: PHD LCSW LCAS RN
Phone: 734-324-8930