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General NPI Number Information
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NPI Number | 1114744356
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Entity Type | Organization
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Legal Business Name | HEADWAY MICHIGAN BEHAVIORAL HEALTH SERVICES, P.C.
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 205 HUDSON ST FL 9
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City | NEW YORK
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State | NY
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Zip | 10013-1810
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | 205 HUDSON ST FL 9
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City | NEW YORK
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State | NY
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Zip | 10013-1810
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Country | US
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Telephone | 646-453-6777
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Fax | 929-596-7897
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARY S. CRALL
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Credential | MD
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Telephone | 951-219-7557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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