Provider Demographics
NPI:1417150889
Name:SCHURGIN, KAREN ANNE (MA PSY S)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:SCHURGIN
Suffix:
Gender:F
Credentials:MA PSY S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 KEVIN CT
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1606
Mailing Address - Country:US
Mailing Address - Phone:248-931-3719
Mailing Address - Fax:
Practice Address - Street 1:29887 W ELEVEN MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1309
Practice Address - Country:US
Practice Address - Phone:248-474-4701
Practice Address - Fax:248-474-1518
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC MH3449101YM0800X
MILPC6401008439101YP2500X
MI6301014092103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional