Provider Demographics
NPI:1093832818
Name:WARGEL, JAMES (PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:WARGEL
Suffix:
Gender:M
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 OLDE TOWNE RD., #81968
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48308-1968
Mailing Address - Country:US
Mailing Address - Phone:248-408-1324
Mailing Address - Fax:
Practice Address - Street 1:200 EAST BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1208
Practice Address - Country:US
Practice Address - Phone:248-457-4559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301003758103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist