MEDICARE: MICHIGAN BEHAVIORAL MEDICINE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	103G00000X	Clinical Neuropsychologist	MI
2	103T00000X	Psychologist	MI
3	104100000X	Social Worker	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1922195999	OTHER	MI	TYPE 2 NPI

General Provider Information

NPI Number	:	1205134525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN BEHAVIORAL MEDICINE

Provider Business Mailing Address
First Line	:	2525 CROOKS RD STE 100
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4733
Country	:	US
Telephone Number	:	248-731-7305
Fax Number	:	248-731-7288

Provider Business Practice Location Address
First Line	:	2525 CROOKS RD STE 100
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4733
Country	:	US
Telephone Number	:	248-731-7305
Fax Number	:	248-731-7288

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. RENE JOSEPH
Credential	:
Telephone Number	:	248-703-1897

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	06/28/2021

Similar Medicare Providers

1942179262 — SUZAN SAAD YACOUB JOHNSON PMHNP
Practice Location Address:

2525 CROOKS RD STE 100
TROY, MI
48084-4733

Practice Phone: 248-731-7305
Practice Fax:

1033215033 — MS. SHARON GARANT LMSW
Practice Location Address:

2525 CROOKS RD , STE. 100
TROY, MI
48084-4733

Practice Phone: 248-731-7305
Practice Fax: 248-731-7388

1144317116 — MICHIGAN BEHAVIORAL MEDICINE PLLC
Practice Location Address:

2525 CROOKS RD , SUITE #101
TROY, MI
48084-4733

Practice Phone: 248-731-7305
Practice Fax:

1922195999 — DR. KALAPPURACKAL CHACKO JOSEPH MD
Practice Location Address:

2525 CROOKS RD , STE 100
TROY, MI
48084-4733

Practice Phone: 248-740-9360
Practice Fax: 248-740-9374

1316060114 — DR. JACKSON E TURNER JR. PH.D.
Practice Location Address:

2525 CROOKS RD STE 100
TROY, MI
48084-4733

Practice Phone: 248-731-7305
Practice Fax: 248-731-7388

1629401237 — MICHIGAN BEHAVIORAL HEALTH
Practice Location Address:

2525 CROOKS RD
TROY, MI
48084-4733

Practice Phone: 248-703-1897
Practice Fax:

Directions to “MICHIGAN BEHAVIORAL MEDICINE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.