Provider Demographics
NPI:1164153284
Name:RESILIENCE PSYCHOTHERAPY OF CENTRAL MICHIGAN
Entity Type:Organization
Organization Name:RESILIENCE PSYCHOTHERAPY OF CENTRAL MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSCHBACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-773-3165
Mailing Address - Street 1:1739 STOCKMAN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4218
Mailing Address - Country:US
Mailing Address - Phone:989-773-3165
Mailing Address - Fax:
Practice Address - Street 1:411 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2446
Practice Address - Country:US
Practice Address - Phone:989-773-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty