Provider Demographics
NPI:1225693997
Name:ANN ARBOR BEHAVIORAL SERVICES PLLC
Entity Type:Organization
Organization Name:ANN ARBOR BEHAVIORAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREGG
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-945-3530
Mailing Address - Street 1:3200 W LIBERTY RD STE G
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9746
Mailing Address - Country:US
Mailing Address - Phone:734-680-6674
Mailing Address - Fax:
Practice Address - Street 1:3200 W LIBERTY RD STE G
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9746
Practice Address - Country:US
Practice Address - Phone:734-680-6674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty