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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