Provider Demographics
NPI:1073541769
Name:BIOLOGICAL PSYCHIATRY CENTER, P.C.
Entity Type:Organization
Organization Name:BIOLOGICAL PSYCHIATRY CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-773-6020
Mailing Address - Street 1:25869 KELLY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4997
Mailing Address - Country:US
Mailing Address - Phone:586-773-6020
Mailing Address - Fax:586-773-6093
Practice Address - Street 1:25869 KELLY RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4997
Practice Address - Country:US
Practice Address - Phone:586-773-6020
Practice Address - Fax:586-773-6093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI018073103TC0700X, 1041C0700X, 106H00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N99030Medicare ID - Type UnspecifiedPH.D. NUMBER
MI0N99040Medicare ID - Type UnspecifiedM.S.W. NUMBER
MI0N99050Medicare ID - Type UnspecifiedM.D. NUMBER