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General NPI Number Information
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NPI Number | 1588528574
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL ASSESSMENT AND COUNSELING CENTER
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 11633 WILLOW POINT DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-1699
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Country | US
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Telephone | 760-717-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 3403 VETERANS DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-4510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MAUREEN HALLETT
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Credential |
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Telephone | 760-717-5113
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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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