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General NPI Number Information
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NPI Number | 1538457932
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Entity Type | Organization
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Legal Business Name | PHELPS PARTNERS, PC
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 4200 W MICHIGAN AVE SUITE 211
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City | KALAMAZOO
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State | MI
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Zip | 49006-5892
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Country | US
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Telephone | 269-370-3038
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Fax | 269-743-4188
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Provider Business Mailing Address
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Address Line | 4200 W MICHIGAN AVE SUITE 211
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City | KALAMAZOO
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State | MI
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Zip | 49006-5892
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Country | US
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Telephone | 269-370-3038
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Fax | 269-743-4188
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHELLY M PHELPS
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Credential | MA, TLLP, CH.T
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Telephone | 269-370-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6301014756
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License Number State | MI
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