Provider Demographics
NPI:1437778966
Name:BRIAN POWERS, MA LLP PC
Entity Type:Organization
Organization Name:BRIAN POWERS, MA LLP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLP
Authorized Official - Phone:313-675-9886
Mailing Address - Street 1:18348 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3219
Mailing Address - Country:US
Mailing Address - Phone:313-675-9886
Mailing Address - Fax:313-216-1840
Practice Address - Street 1:18348 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3219
Practice Address - Country:US
Practice Address - Phone:313-675-9886
Practice Address - Fax:313-216-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty