Organization
MICHIGAN BEHAVIORAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE JOSEPH (ADMINISTRATOR)
(248) 703-1897
Entity
Organization
Contact information
Practice address
2525 CROOKS RD, SUITE #101, TROY, MI 48084-4733
(248) 731-7305
Mailing address
2525 CROOKS RD, SUITE #100, TROY, MI 48084-1426
(248) 731-7305
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10487
BLUE CROSS NUMBER
MA
Enumeration date
10/09/2006
Last updated
05/28/2019
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