Organization
BEACON PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN STARON (LIMITED LICENSED PSYCHOLOGIST)
(248) 497-3411
Entity
Organization
Contact information
Practice address
33150 SCHOOLCRAFT RD STE L03, LIVONIA, MI 48150-1631
(248) 497-3411
Mailing address
195 SHINNECOCK DR, BRIGHTON, MI 48114-8832
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/10/2019
Last updated
06/10/2019
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