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General NPI Number Information
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NPI Number | 1083254031
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Entity Type | Organization
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Legal Business Name | CK PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 215 ANN ARBOR RD W STE 206
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City | PLYMOUTH
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State | MI
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Zip | 48170-2251
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Country | US
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Telephone | 313-687-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 48356 WADEBRIDGE DR
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City | CANTON
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State | MI
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Zip | 48187-1225
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Country | US
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Telephone | 734-306-9507
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CELENA N KHATIB
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Credential |
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Telephone | 313-687-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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