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NPI Code Detail

MEDICARE: RIVER'S BEND, P.C.

MEDICARE: RIVER'S BEND, P.C.
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
1101YM0800XMental Health Counselor630848MI
2101YM0800XMental Health Counselor
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
4101YA0400XAddiction (Substance Use Disorder) Counselor630848MI

General Provider Information

NPI Number : 1265520209
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER'S BEND, P.C.
Provider Business Mailing Address
First Line : 550 STEPHENSON HWY STE 200
Second Line :
City : TROY
State : MI
Zip : 48083-1132
Country : US
Telephone Number : 248-585-3239
Fax Number : 248-616-9759
Provider Business Practice Location Address
First Line : 550 STEPHENSON HWY STE 200
Second Line :
City : TROY
State : MI
Zip : 48083-1132
Country : US
Telephone Number : 248-585-3239
Fax Number : 248-616-9759
Authorized Official
Title or Position : OFFICE MANAGER
Name : AMY LEE BUCHANAN
Credential :
Telephone Number : 248-585-3239
Provider Enumeration Date : 10/11/2006
Last Update Date : 04/28/2025

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1972273746 — HOLLY R WICKHAM LMSW, LCSW
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1689338451 — AUTUMN MARGARET KARAFA
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Directions to “RIVER'S BEND, P.C. ” Practice Location

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