Provider Demographics
NPI:1003400474
Name:NEUROBEHAVIORAL SERVICES, P.C.
Entity Type:Organization
Organization Name:NEUROBEHAVIORAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:ALEXSANDRA
Authorized Official - Last Name:SEKULOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-569-8700
Mailing Address - Street 1:29260 FRANKLIN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1182
Mailing Address - Country:US
Mailing Address - Phone:248-569-8700
Mailing Address - Fax:248-681-9151
Practice Address - Street 1:29260 FRANKLIN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-569-8700
Practice Address - Fax:248-856-9373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty