Provider Demographics
NPI:1235882192
Name:PROGRESSIVE PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE PSYCHOLOGY, INC.
Other - Org Name:JENNIFER FELIX, MA, LLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-337-3191
Mailing Address - Street 1:1510 MOHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3334
Mailing Address - Country:US
Mailing Address - Phone:248-890-3590
Mailing Address - Fax:
Practice Address - Street 1:1320 N CAMPBELL RD STE 13
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1555
Practice Address - Country:US
Practice Address - Phone:248-890-3590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty