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Organization

MICHIGAN PSYCHIATRIC & BEHAVIORAL ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LISA M WILLIAMS BA, LBSW (CREDENTIALING COORDINATOR)
(989) 922-4900
Entity
Organization

Contact information

Practice address
690 S TRUMBULL ST, BAY CITY, MI 48708-7692
(989) 922-4900
(989) 922-4911
Mailing address
690 S TRUMBULL ST, BAY CITY, MI 48708-7692
(989) 922-4900
(989) 922-4911

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
ON34080
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1080046
NCCPA
MI
05
4318064
MI
05
4318073
MI
05
4318091
MI
01
4704114058
NURSE PRACTITIONER
MI
01
561005082
PHYSICIAN'S ASSISTANT
MI
01
KK058857
LICENSE
MI
01
MI055552
LICENSE
MI
01
ML073076
LICENSE
MI
01
ON34080
GROUP MEDICARE
MI
Enumeration date
06/23/2010
Last updated
03/07/2023
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