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General NPI Number Information
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NPI Number | 1427229095
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MICHIGAN PSYCHOLOGICAL CLINIC
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 210 S 5TH AVE
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City | ANN ARBOR
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State | MI
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Zip | 48104
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Country | US
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Telephone | 734-615-7853
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Fax | 734-764-8128
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Provider Business Mailing Address
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Address Line | 210 S 5TH AVE
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City | ANN ARBOR
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State | MI
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Zip | 48104
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Country | US
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Telephone | 734-615-7853
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Fax | 734-764-8128
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Authorized Official
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Title or Position | CLINIC AND OPERATIONS MANAGER
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Name | MEAGJAN FESLER
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Credential | M.S. , LLP
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Telephone | 734-764-2961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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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