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NPI Code Detail

MEDICARE: OCD AND ANXIETY MICHIGAN, PLLC

MEDICARE: OCD AND ANXIETY MICHIGAN, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1154884948
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCD AND ANXIETY MICHIGAN, PLLC
Provider Business Mailing Address
First Line : PO BOX 482
Second Line :
City : EMPIRE
State : MI
Zip : 49630-0482
Country : US
Telephone Number : 231-256-1167
Fax Number : 231-252-2147
Provider Business Practice Location Address
First Line : 135 N OLD WOODWARD AVE STE 200
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48009-3341
Country : US
Telephone Number : 231-256-1167
Fax Number : 231-525-2147
Authorized Official
Title or Position : OWNER, CLINICIAN
Name : MS. JENNIFER LYN OVERTON
Credential : LMSW-C, LCSW, LISW-C
Telephone Number : 231-256-1167
Provider Enumeration Date : 04/09/2019
Last Update Date : 04/19/2023

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Directions to “OCD AND ANXIETY MICHIGAN, PLLC ” Practice Location

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