Provider Demographics
NPI:1396833208
Name:SERMIC PSYCHOLOGICAL AND COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:SERMIC PSYCHOLOGICAL AND COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:989-576-0554
Mailing Address - Street 1:116 W SUPERIOR ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1650
Mailing Address - Country:US
Mailing Address - Phone:989-576-0554
Mailing Address - Fax:989-463-6390
Practice Address - Street 1:116 W SUPERIOR ST
Practice Address - Street 2:SUITE 4
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1650
Practice Address - Country:US
Practice Address - Phone:989-576-0554
Practice Address - Fax:989-463-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012763103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty