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General NPI Number Information
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NPI Number | 1134273766
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Entity Type | Organization
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Legal Business Name | HEALTH PSYCHOLOGY PC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 3335 S. 9TH STREET
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City | KALAMAZOO
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State | MI
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Zip | 49009
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Country | US
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Telephone | 269-375-0624
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Fax | 269-375-0008
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Provider Business Mailing Address
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Address Line | P.O. BOX 263
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City | OSHTEMO
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State | MI
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Zip | 49077-0263
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Country | US
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Telephone | 269-375-0624
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Fax | 269-375-0008
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | PATRICIA R. WILLIAMS
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Credential | LMSW
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Telephone | 269-375-0624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801065401
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301001976
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License Number State | MI
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