Provider Demographics
NPI:1336279272
Name:DIMENSIONS THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:DIMENSIONS THERAPEUTIC SERVICES
Other - Org Name:DI MENSIONS MATERNALINFANT SUPPORT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYE
Authorized Official - Middle Name:MYREA
Authorized Official - Last Name:PASCALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-968-2600
Mailing Address - Street 1:21700 GREENFIELD
Mailing Address - Street 2:SUITE277
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:248-968-2600
Mailing Address - Fax:248-968-2626
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE277
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-968-2600
Practice Address - Fax:248-968-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P02620Medicare ID - Type Unspecified