Provider Demographics
NPI:1417280587
Name:JAMES, MICHAEL J (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:JAMES
Suffix:
Gender:M
Credentials:PSYD, LP
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:J
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LP
Mailing Address - Street 1:2006 HOGBACK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9750
Mailing Address - Country:US
Mailing Address - Phone:734-786-2300
Mailing Address - Fax:734-786-4915
Practice Address - Street 1:2006 HOGBACK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9750
Practice Address - Country:US
Practice Address - Phone:734-786-2300
Practice Address - Fax:734-786-4915
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016629103TC0700X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor