Provider Demographics
NPI:1316390784
Name:MOREHEAD, CHRISTOPHER THOMAS (MA,LPC, CAADC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:MOREHEAD
Suffix:
Gender:M
Credentials:MA,LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 DORRE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2104
Mailing Address - Country:US
Mailing Address - Phone:586-213-2772
Mailing Address - Fax:
Practice Address - Street 1:2 CROCKER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2558
Practice Address - Country:US
Practice Address - Phone:586-213-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017580101YM0800X
MIC-03725101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)