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Contact Information

EAST BAY PSYCHOLOGY, PC
3926 VILLAGE CIRCLE DR.
TRAVERSE CITY, MI49686
 Phone: 231-938-5900
 Fax: 231-938-5900
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for EAST BAY PSYCHOLOGY PC · (Female)

NPI # 1417346966
Status Active
Credentials
Entity Individual
Enumeration date 01/21/2015
Last updated 01/23/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 6301002718
  • MI Other 0B81230 BCBS-M
  • MI Other 0Z5488 BCBS-M
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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