Provider Demographics
NPI:1497054902
Name:PSYCHWORKS CSH
Entity Type:Organization
Organization Name:PSYCHWORKS CSH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:248-667-8885
Mailing Address - Street 1:41011 CAYENNE DR.
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3918
Mailing Address - Country:US
Mailing Address - Phone:248-667-8885
Mailing Address - Fax:
Practice Address - Street 1:900 WILSHIRE DR
Practice Address - Street 2:STE 202
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-1600
Practice Address - Country:US
Practice Address - Phone:248-667-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014573103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4703Medicare PIN