MEDICARE: SOUTHFIELD MENTAL HEALTH ASSOCIATES PC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	302643	OTHER	MI	VALUE OPTIONS
2	7509106210	OTHER	MI	BLUE CROSS MICHIGAN

General Provider Information

NPI Number	:	1619015872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHFIELD MENTAL HEALTH ASSOCIATES PC

Provider Business Mailing Address
First Line	:	17320 W 12 MILE RD
Second Line	:	SUITE 101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2102
Country	:	US
Telephone Number	:	248-557-3606
Fax Number	:	248-557-4697

Provider Business Practice Location Address
First Line	:	17320 W 12 MILE RD
Second Line	:	SUITE 101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2102
Country	:	US
Telephone Number	:	248-557-3606
Fax Number	:	248-557-4697

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. LAWRENCE J GUSMAN
Credential	:	PHD
Telephone Number	:	248-557-3606

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1588515423 — PHOEBEE JEAN
Practice Location Address:

17320 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-727-3456
Practice Fax:

1326184912 — MRS. LAURA SACKS KOHN MA LPC
Practice Location Address:

17320 W 12 MILE RD , SUITE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-227-5451
Practice Fax: 248-557-4697

1124166822 — DAVID ZAPORSKI MSW
Practice Location Address:

17320 W 12 MILE RD , SUITE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-302-0027
Practice Fax: 248-557-4697

1649318346 — MS. SUSIE T SYMONS MA LLP LPC
Practice Location Address:

17320 W 12 MILE RD , SUITE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-557-4003
Practice Fax: 248-557-4697

1790826444 — MRS. RUBY E KUSHNER MSW
Practice Location Address:

17320 W 12 MILE RD , SUITE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-855-6680
Practice Fax: 248-557-4697

1326697574 — SARA MICHELLE ABRIN
Practice Location Address:

17320 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-2102

Practice Phone: 248-727-3456
Practice Fax:

Directions to “SOUTHFIELD MENTAL HEALTH ASSOCIATES PC ” 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.