Provider Demographics
NPI:1376769430
Name:FURMAN, PAULINE JONES (PHD, MED,MSW,LPC)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:JONES
Last Name:FURMAN
Suffix:
Gender:F
Credentials:PHD, MED,MSW,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30555 SOUTHFIELD RD
Mailing Address - Street 2:340
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-7752
Mailing Address - Country:US
Mailing Address - Phone:248-443-8494
Mailing Address - Fax:248-443-8496
Practice Address - Street 1:30555 SOUTHFIELD RD
Practice Address - Street 2:340
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7752
Practice Address - Country:US
Practice Address - Phone:248-443-8494
Practice Address - Fax:248-443-8496
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005377101YA0400X
MI6801034824101YM0800X, 101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401005377OtherLICENSE NUMBER
MI20892464OtherBCBS
MI383251904OtherEIN
MI6401005377OtherLICENSE NUMBER