Healthcare Provider Details

I. General information

NPI: 1356783518
Provider Name (Legal Business Name): ASHLEY R BADE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY YOUNG

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HAGGERTY RD STE 2160
WEST BLOOMFIELD MI
48323-2192
US

IV. Provider business mailing address

2300 HAGGERTY RD STE 2120
WEST BLOOMFIELD MI
48323-2191
US

V. Phone/Fax

Practice location:
  • Phone: 248-859-2473
  • Fax: 248-620-6405
Mailing address:
  • Phone: 248-859-2457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704299169
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704299169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: