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General NPI Number Information
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NPI Number | 1861613887
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Entity Type | Organization
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Legal Business Name | CLAUDE W. EGGERTSEN, PHD, PLLC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 288 S MAIN ST STE. 1
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City | ROMEO
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State | MI
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Zip | 48065-5133
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Country | US
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Telephone | 586-752-0091
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Fax | 586-677-7809
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Provider Business Mailing Address
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Address Line | PO BOX 747
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City | WASHINGTON
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State | MI
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Zip | 48094-0747
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Country | US
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Telephone | 586-752-0091
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Fax | 596-677-7809
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Authorized Official
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Title or Position | PRESIDENT, OWNER
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Name | CLAUDE W. EGGERTSEN
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Credential | PHD
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Telephone | 586-752-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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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 | 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 #3
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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