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General NPI Number Information
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NPI Number | 1356951271
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Entity Type | Organization
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Legal Business Name | AUTHENTICITY PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1500 N STEPHENSON HWY
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City | ROYAL OAK
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State | MI
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Zip | 48067-1580
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Country | US
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Telephone | 773-318-5567
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Fax |
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Provider Business Mailing Address
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Address Line | 510 S ROCHESTER RD
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City | CLAWSON
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State | MI
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Zip | 48017-2124
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Country | US
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Telephone | 773-318-5567
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELISSA FARRELL
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Credential | PSYD
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Telephone | 773-318-5567
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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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