Healthcare Provider Details

I. General information

NPI: 1033227269
Provider Name (Legal Business Name): PERSPECTIVES OF TROY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 W BIG BEAVER RD STE 1450
TROY MI
48084-4762
US

IV. Provider business mailing address

888 W BIG BEAVER RD STE 1450
TROY MI
48084-4762
US

V. Phone/Fax

Practice location:
  • Phone: 248-322-0003
  • Fax: 248-244-1330
Mailing address:
  • Phone: 248-244-8644
  • Fax: 248-244-1330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELLIOTT RICHELSON
Title or Position: PRESIDENT, TREASURER, SECRETARY
Credential:
Phone: 904-605-4986