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UNIVERSITY PHYSICIAN GROUP NPI 1356556575


NPI Information

NPI: 1356556575
Provider Name: UNIVERSITY PHYSICIAN GROUP

Doing Business As: WAYNE STATE UNIVERSITY PHYSICIAN GROUP

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
16836 NEWBURGH RD
LIVONIA, MI
ZIP 48154
Phone: (734) 464-4220
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UNIVERSITY PHYSICIAN GROUP is a counselor in Livonia, MI. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. UNIVERSITY PHYSICIAN GROUP NPI is 1356556575. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wayne State University Physician Group.

The provider's business location address is:

16836 NEWBURGH RD
LIVONIA, MI
ZIP 48154-600
Phone: (734) 464-4220
Fax: (734) 464-5885

The provider's authorized official is Jeffery P Kohlitz .
The authorized official title is Chief Financial Officer and has the following contact phone number (248) 581-5930.

The enumeration date for this NPI number is 5/11/2007 and was last updated on 10/26/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical NeuropsychologistNo
2103T00000XPsychologistNo
3104100000XSocial WorkerNo
4106H00000XMarriage & Family TherapistNo
52084P0800XPsychiatry & NeurologyPsychiatryNo
6101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10H22830OTHERMICHIGANBCBSM GROUP # - NP
20H22832OTHERMICHIGANBCBSM GROUP # - MD/DO
30P32050OTHERMICHIGANMEDICARE GROUP # - SOCIAL WORKER
40H22874OTHERMICHIGANBCBSM GROUP # - PSYCHOLOGIST/NEUROPSYCHOLOGIST
50P32060OTHERMICHIGANMEDICARE GROUP # - PSYCHOLOGIST/NEUROPSYCHOLOGIST
60P32120OTHERMICHIGANMEDICARE GROUP # - MD/DO FEE LOCALITY 99
70P32180OTHERMICHIGANMEDICARE GROUP # - NP
80H22872OTHERMICHIGANBCBSM GROUP # - SOCIAL WORKER
90P30630OTHERMICHIGANMEDICARE GROUP # - MD/DO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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