Provider Demographics
NPI:1447201710
Name:FAMILY THERAPY ASSOCIATES OF ANN ARBOR
Entity Type:Organization
Organization Name:FAMILY THERAPY ASSOCIATES OF ANN ARBOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZONA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHEINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-572-0882
Mailing Address - Street 1:118 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4910
Mailing Address - Country:US
Mailing Address - Phone:734-572-0882
Mailing Address - Fax:734-663-9789
Practice Address - Street 1:118 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4910
Practice Address - Country:US
Practice Address - Phone:734-572-0882
Practice Address - Fax:734-663-9789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001824103T00000X
MI68010109171041C0700X
MI68010128791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOH16180Medicare PIN