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General NPI Number Information
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NPI Number | 1851580518
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Entity Type | Organization
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Legal Business Name | OAKLAND PSYCHOLOGICAL CLINIC, P.C.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 29865 6 MILE RD SUITE 112
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City | LIVONIA
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State | MI
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Zip | 48152
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Country | US
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Telephone | 734-522-0280
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Fax | 734-522-3654
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Provider Business Mailing Address
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Address Line | PO BOX 7008
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-7008
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Country | US
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Telephone | 248-322-0003
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Fax | 248-322-0006
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Authorized Official
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Title or Position | PRESIDENT, TREASURER, SECRETARY
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Name | ELLIOTT RICHELSON
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Credential | M.D.
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Telephone | 904-605-4986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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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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