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General NPI Number Information
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NPI Number | 1528208873
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Entity Type | Organization
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Legal Business Name | GERIATRIC PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 9465 COUNSELORS ROW STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3817
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Country | US
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Telephone | 317-805-3000
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Fax | 888-483-0118
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Provider Business Mailing Address
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Address Line | 39465 W 14 MILE RD
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City | NOVI
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State | MI
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Zip | 48377-1600
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Country | US
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Telephone | 248-859-3900
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Fax | 888-483-0118
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | ROBERT A CLEMENTE
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Credential |
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Telephone | 248-859-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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