Provider Demographics
NPI:1376305656
Name:MACADAMS PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:MACADAMS PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:214-912-3587
Mailing Address - Street 1:29551 GREENFIELD RD STE 214
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5872
Mailing Address - Country:US
Mailing Address - Phone:214-912-3587
Mailing Address - Fax:
Practice Address - Street 1:29551 GREENFIELD RD STE 214
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5872
Practice Address - Country:US
Practice Address - Phone:214-912-3587
Practice Address - Fax:313-447-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty